Job Information
Elevance Health Business Analyst III (Pharmaceutical Audit) in Denver, Colorado
Location: Indianapolis IN, Mason OH, Atlanta GA, Norfolk VA, Tampa FL, Denver CO, Los Angeles CA
Hours: M – F East coast Hours of Operation
Travel: Hybrid 1 (1-2 Days onsite per week)
Position Overview:
Responsible for handling high level pharmaceutical claim audits and reviewing claims issues from junior team to ensure claims are being resolved and reported in a timely manner.
How You Will Make an Impact:
Reviews and Audits Pharmaceutical claims processed by vendors to ensure proper compliance
Conducting Data analysis and issue resolution regularly
Acts as a resource to users of PBM software to address questions/issues
Vendor interaction and stakeholder management responsibilities
Develops project plans and identifies and coordinates resources, involving those outside the unit
Works with programming staff to ensure requirements will be incorporated into system design and testing
May provide direction and guidance to team members and serves as an expert for the team
Required Qualifications:
- Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.
Preferred Qualifications:
Pharmacy Claims Audit Strongly preferred
PBM (Pharmacy Benefit Management) Software Experience Strongly preferred
Experience working in an Agile environment strongly preferred
PBM (Pharmacy Benefit Management) Benefits experience preferred
Healthcare experience Strongly preferred
Data analysis and issue resolution experience preferred
SQL experience is preferred
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $69,120 to $124,416
Locations: California; Colorado
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 considered to be 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.