Formulary Business Analyst II - CarelonRx
Elevance Health, Columbus, Ohio, United States, 43224
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. Alternate locations may be considered if candidates reside within a commuting distance from an office. About CarelonRx
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. Role
The
Business Analyst II - Health Insurance Exchange
will support Clinical Pharmacy Services staff with implementation and maintenance of clinical programs and formularies. Responsible for developing project plans and leading small projects to completion. How You Will Make An Impact
Acts as liaison with clinical team to coordinate timely and accurate completion of various business deliverables. Maintains clinical formulary/utilization management (prior authorization, step therapy & quantity limits) in web-based formulary management tool, Formulary Navigator. Supports communication of clinical program and formulary changes to members and providers as well as internal stakeholders. Supports quality assurance processes of clinical programs and formulary strategy. Supports compliance with PBM Accreditation requirements. Supports departmental compliance with state and federal regulations. Conducts root cause analysis of processes and issues, identifies, and makes recommendations for improvements, and develops documentation. Communicates plans, status, and issues within the team, group, or project, including business members and management. Minimum Requirements
Requires a BS/BA degree in related field and a minimum of 2 years related operational and/or data analysis experience, experience in database structures, and standard query and reporting tools; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities, And Experiences
Experience with Excel skills strongly desired. PBM or pharmacy experience (e.g. pharmacy technician, Formulary Product Manager) strongly preferred. Experience with Medicaid formularies preferred. Experience with Python, SAS, or SQL preferred. Formulary Software tool (e.g. Formulary Navigator, RxFlex) experience strongly preferred. Salary and Locations
For candidates working in person or virtually in the below location(s), the salary range for this specific position is $61,680 to $111,024. Locations: California; Columbus, OH; Illinois; Minnesota; New Jersey; Washington State About Elevance Health / How We Work
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. We offer a range of market-competitive total rewards including medical, dental, vision, 401(k) matching, retirement plans, and other benefits as described in our benefits overview. 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. Equal Opportunity
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 may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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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. Alternate locations may be considered if candidates reside within a commuting distance from an office. About CarelonRx
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. Role
The
Business Analyst II - Health Insurance Exchange
will support Clinical Pharmacy Services staff with implementation and maintenance of clinical programs and formularies. Responsible for developing project plans and leading small projects to completion. How You Will Make An Impact
Acts as liaison with clinical team to coordinate timely and accurate completion of various business deliverables. Maintains clinical formulary/utilization management (prior authorization, step therapy & quantity limits) in web-based formulary management tool, Formulary Navigator. Supports communication of clinical program and formulary changes to members and providers as well as internal stakeholders. Supports quality assurance processes of clinical programs and formulary strategy. Supports compliance with PBM Accreditation requirements. Supports departmental compliance with state and federal regulations. Conducts root cause analysis of processes and issues, identifies, and makes recommendations for improvements, and develops documentation. Communicates plans, status, and issues within the team, group, or project, including business members and management. Minimum Requirements
Requires a BS/BA degree in related field and a minimum of 2 years related operational and/or data analysis experience, experience in database structures, and standard query and reporting tools; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities, And Experiences
Experience with Excel skills strongly desired. PBM or pharmacy experience (e.g. pharmacy technician, Formulary Product Manager) strongly preferred. Experience with Medicaid formularies preferred. Experience with Python, SAS, or SQL preferred. Formulary Software tool (e.g. Formulary Navigator, RxFlex) experience strongly preferred. Salary and Locations
For candidates working in person or virtually in the below location(s), the salary range for this specific position is $61,680 to $111,024. Locations: California; Columbus, OH; Illinois; Minnesota; New Jersey; Washington State About Elevance Health / How We Work
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. We offer a range of market-competitive total rewards including medical, dental, vision, 401(k) matching, retirement plans, and other benefits as described in our benefits overview. 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. Equal Opportunity
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 may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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