PBM Business Change Manager
Anticipated End Date
Position Title
Hybrid
Alternate locations may be considered if candidates reside within a commuting distance from an office.
How you will make an impact
- Identifies potential issues, project charge, and scope.
- Leads efforts to identify best practices.
- Identifies impacted parties, business partners, and resources required.
- Develops and designs processes and systems that support business needs.
- Designs methods for integrating function and process.
- Conducts cost/benefit analyses.
- Builds support for business change throughout the business unit.
Minimum Requirements
- Requires a BA/BS in a related field and minimum of 5 years process or project related experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences
- Strong PBM/Pharmacy domain experience, including pharmacy Benefits, Claims Adjudication, Members/Eligibility, Clinical/UM, Networks, Products, and Accumulators.
- Demonstrated experience leading end-to-end UAT, including UAT strategy, test planning, test case development, execution, regression, defect management, business sign-off, and production validation.
- Hands-on experience with pharmacy claim submission and validation, including interpreting benefit configurations and validating claim outcomes against expected business rules.
- Experience reviewing and translating business/functional requirements into comprehensive UAT scenarios, test cases, and acceptance criteria for web-based applications, APIs, and integrated solutions.
- Strong analytical and problem-solving capabilities, including root-cause analysis, defect triage, business impact assessment, and coordination with Product and IT teams through resolution.
- Experience leading onshore/offshore testing resources, including work allocation, execution tracking, dependency management, issue escalation, and consolidation of project status.
- Strong cross-functional stakeholder management and communication skills, with experience partnering with Business, Product, IT, Operations, and SMEs and providing concise status, risk, and release-readiness reporting to senior leadership.
- Hands-on experience with JIRA, Smartsheet, or similar tools for test execution, defect tracking, metrics, dashboards, and project reporting; ability to manage multiple workstreams and drive activities through successful production implementation.
- Working knowledge of ChatGPT, Microsoft Copilot, and other GenAI tools to support testing process improvements.
- Experience in successfully developing and managing projects with fairly significant operating budget and knowledge of process redesign.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $85,680 to $141,372
Location(s): Illinois, Virginia.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Job Level
Workshift
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NOTE
Not included in the source posting: what you'll do, benefits.
Skills
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