PBM Strategy & Analytics Consultant (Hybrid)

Elevance Health; Tampa (FL); Hybride; USD 88 000 - 132 000; Plein temps

Résumé du poste

Elevation Health is seeking a PBM Business Consultant to translate complex business needs into software requirements and lead cross‑functional teams. The role emphasizes business analysis, data-driven decision making, and collaboration across Operations, Product, Technology, and Finance to drive improvements in PBM processes and controls.

The position requires a BA/BS and 8+ years of experience in business analysis, with preferred knowledge of PBM operations, claims adjudication, and benefit

Qualifications

• Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background.
• Experience with PBM operations, pharmacy claims adjudication, and benefit configuration is preferred.
• Healthcare, PBM, compliance, or operational consulting experience preferred.

Responsabilités

• May lead teams of analysts assigned to complex projects.
• Determines specific business application software requirements to address complex and varied business needs.
• Analyzes and designs solutions to address complex and varied business needs.
• Consults with business partners concerning application and implementation of technology.
• Lead restitution reviews and operational investigations to assess member, client, and financial impacts.
• Conduct complex business and claims data analyses to quantify impact, identify trends, and support remediation recommendations.
• Partner with cross-functional teams to evaluate risks and develop corrective actions.
• Facilitate root cause analysis efforts and drive process improvements.

Connaissances

Lead teams of analysts

Translate complex findings

Cross-functional collaboration

Analytical thinking

Formation

BA/BS

Outils

Excel

SQL

Databricks

Description du poste

Elevation Health is seeking a PBM Business Consultant to translate complex business needs into software requirements and lead cross‑functional teams. The role emphasizes business analysis, data-driven decision making, and collaboration across Operations, Product, Technology, and Finance to drive improvements in PBM processes and controls.

The position requires a BA/BS and 8+ years of experience in business analysis, with preferred knowledge of PBM operations, claims adjudication, and benefit