Pharmacy Benefit Manager Compliance Manger - Client Audit

The Elevance Health Companies, Inc.; St. Louis (MO); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Benefit Manager Compliance Manager – Client Audit to coordinate PBM compliance activities and lead internal and external audits across the enterprise.

The role supports HIPAA, SOX and privacy initiatives; requires in-office 1-2 days per week with hybrid options. A BA/BS with 6+ years of experience is expected. Travel to worksites may be required.

Qualifications

• Requires a BA/BS and minimum of 6 years experience; or any combination of education and experience, which would provide an equivalent background.

Responsibilities

• Identifies, monitors, revises and tracks business unit processes to ensure compliance.
• Identifies risks associated with PBM activities and mitigates them.
• Partners with business units to ensure audit requirements are met.
• Participates as compliance SME on mandated projects for HIPAA, SOX and privacy initiatives.
• Directs audits and responds to findings, both internal and external.
• Develops training and communication plans for compliance programs.

Skills

Regulatory compliance

Audit coordination

HIPAA & SOX

Education

BA/BS

Job description

Anticipated End Date: 2026-10-14 Position Title: Pharmacy Benefit Manager Compliance Manger - Client Audit

Job Description

Pharmacy Benefit Manager Compliance Manager – Client Audit Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Pharmacy Benefit Manager Compliance Manager – Client Audit is responsible for coordinating pharmacy compliance activities and initiatives across the PBM and the enterprise by maintaining department approved audit plan and implementing effective internal controls.

How You Will Make an Impact

• Identifies, monitors, revises and tracks business unit processes and implementing procedures to ensure compliance with all related measures.
• Identifies potential risks associated with PBM activities and ensures procedures are in place to minimize risks.
• Partners with business units to ensure compliance with audit requirements.
• Participates as compliance subject matter expert on all mandated projects; achieves business operational compliance with all related measures relative to HIPAA and SOX and Privacy and Security Office initiatives.
• Conducts, directs, leads and facilitates all activities related to Internal and External (Regulatory and Client) audits and responds to findings.
• Performs high level audit research, develops strategic plans and pro‑actively anticipates business needs and requirements.
• Develops and implements training and communication plans; manages and leads scheduled and ad‑hoc compliance projects; provides and delivers compliance consultation services to the business unit.

Minimum Requirements

Requires a BA/BS and minimum of 6 years experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences

Travels to worksite and other locations as necessary.

Job Details

Job Level: Non-Management Exempt

Workshift: Job Family: FRD > Compliance

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Rewards & Benefits

We offer a range of market‑competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member‑facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.

Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.