Pharmacy Implementation Manager Senior

Elevance Health; St. Louis (MO); Hybrid; USD 110,000 - 150,000; Part time

Job summary

Elevance Health is seeking an Implementation Manager Senior to lead and plan workstreams across implementation projects for a portfolio of cross-service offerings. This hybrid role requires in-office presence 1-2 days per week and allows some flexibility to support productivity and work-life balance from nearby offices.

You will maintain knowledge of product offerings, partner with leadership to improve process quality, and define requirements for implementations.

Qualifications

• Requires BA/BS degree in related field with a minimum of 5 years' experience in health insurance field which includes 3 years' experience in leading workstreams and/or solutioning projects.
• Graduate degree and/or professional designation related to field.
• Experience with project management.
• Ability to communicate information clearly and concisely, both orally and in writing, in a professional and legal environment.
• Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in PBM.
• Formulary, clinical rules, pharmacy claims analysis, and/or prior authorization experience for a pharmacy benefit manager or health plan.

Responsibilities

• Lead and plan workstreams across implementation projects for a portfolio of cross-service offerings.
• Partner with leadership across business units to identify opportunities and drive progress on overall process improvements to ensure continual, measurable improvement of implementation quality, compliance, and speed of execution.
• Review and/or define functional, usability, reliability, performance, and support requirements related to an implementation.
• Make data-driven decisions and translate data.
• Support operational readiness through feature testing by creating/testing directly or partnering with SME in service area.
• Plans implementation timeline and milestones, tracks progress, monitors and communicates project status, identifies and resolves issues utilizing pre-established governance and stakeholders for escalation and issue resolution.

Skills

Project management

Communication

Policy knowledge

Pharmacy claims analysis

Prior authorization

Education

BA/BS degree in related field

Graduate degree

Professional designation

Job description

Location: Open Pulsepoint

Location: Open Pulsepoint

Hybrid: 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 Implementation Manager Senior is responsible for leading and/or planning workstreams across implementation projects, for a portfolio of cross-service (multiple BU's) diverse service offerings for both internal and external clients.

How You Will Make An Impact

• Maintain depth of knowledge of product offerings - key relationship owner between implementation and product teams to support end-to-end solutioning of service implementations.
• Partner with leadership across business units to identify opportunities and drive progress on overall process improvements to ensure continual, measurable improvement of implementation quality, compliance, and speed of execution.
• Review and/or define functional, usability, reliability, performance, and support requirements related to an implementation.
• Make data-driven decisions and translate data.
• Support operational readiness through feature testing by creating/testing directly or partnering with SME in service area.
• Plans implementation timeline and milestones, tracks progress, monitors and communicates project status, identifies and resolves issues utilizing pre-established governance and stakeholders for escalation and issue resolution.

Minimum Qualifications

• Requires BA/BS degree in related field with a minimum of 5 years' experience in health insurance field which includes 3 years' experience in leading workstreams an/or solutioning projects ; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, And Experiences

• Graduate degree and/or professional designation related to field.
• Experience with project management.
• Ability to communicate information clearly and concisely, both orally and in writing, in a professional and legal environment.
• Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in PBM.
• Formulary, clinical rules, pharmacy claims analysis, and/or prior authorization experience for a pharmacy benefit manager or health plan.

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.

• 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 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.