PBM Change Manager — Hybrid Strategy & Process Lead

Elevance Health; Ashburn (VA); Hybrid; USD 86,000 - 141,000; Full time

Benefits offered by this job

Hybrid work model

Competitive benefits

Job summary

Elevance Health’s PBM Business Change Manager role is a hybrid position requiring in-office presence 1-2 days per week. The role focuses on identifying and implementing projects, programs and plans that align with business and enterprise goals.

Candidates should have a BA/BS with 5+ years of process or project experience and strong PBM/pharmacy domain knowledge, including claims adjudication and eligibility. Excellent stakeholder management and UAT leadership are essential.

Qualifications

• BA/BS in related field required.
• Minimum 5 years process or project related experience.
• Strong PBM/Pharmacy domain experience including benefits, claims adjudication, eligibility, clinical/UM, networks, products, accumulators.
• Experience leading end-to-end UAT, including strategy, planning, test case development, execution, regression, defect management, and production sign-off.
• Hands-on experience with pharmacy claim submission and validation against business rules.
• Experience translating requirements into UAT scenarios, test cases, and acceptance criteria for web apps, APIs, and integrated solutions.
• Strong analytical and problem-solving capabilities, including root-cause analysis and coordination with Product and IT teams.

Responsibilities

• Identify issues, project charge, and scope.
• Lead efforts to identify best practices.
• Identify impacted parties, business partners, and resources required.
• Design processes and systems to support business needs.
• Design methods for integrating function and process.
• Conduct cost/benefit analyses.
• Build support for business change across the unit.

Job description

Elevance Health’s PBM Business Change Manager role is a hybrid position requiring in-office presence 1-2 days per week. The role focuses on identifying and implementing projects, programs and plans that align with business and enterprise goals.

Candidates should have a BA/BS with 5+ years of process or project experience and strong PBM/pharmacy domain knowledge, including claims adjudication and eligibility. Excellent stakeholder management and UAT leadership are essential.