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Business Analyst III

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR8218


  • Ohio, Ohio
  • Texas, Texas
  • Arizona, Arizona
  • Nevada, Nevada
  • Virginia, Virginia
  • Illinois, Illinois
  • Washington, Washington
  • Georgia, Georgia
  • Wisconsin, Wisconsin
  • Kentucky, Kentucky
  • Missouri, Missouri
  • Oregon, Oregon
  • Connecticut, Connecticut
  • New York, New York
  • New Hampshire, New Hampshire
  • Maine, Maine



Build the Possibilities. Make an extraordinary impact. '

The Business Analyst III position is responsible for analyzing pharmacy benefit coding systems against business criteria. Works on quality review with a diverse scope in which the analysis of data requires evaluation in comparison to system findings and per department policies and procedures. Provides written and/or verbal feedback to peers and/or internal stakeholders. Collaboratively identifies areas of pharmacy plan build improvement with other departments to ensure plan build accuracy. Responsible for driving service quality excellence by evaluating the accuracy of a pharmacy plan build. Serves as a subject matter expert on pharmacy benefits and pharmacy coding system setup.

How you will make an impact:

  • Perform pharmacy benefit quality reviews for multiple lines of business, functions, and systems.

  • Apply company and team policy and procedures.

  • Recognize, analyze, and design solutions to address complex and varied business needs.

  • Consult with business partners concerning the application and implementation of technology.

  • Identify, document, and report any benefit errors and communicates issues promptly to ensure rapid resolution.

  • Analyze and interpret data and make recommendations for change based on pharmacy operations procedures, system requirements, judgment, and experience.

  • Identify, assess, and mitigate risk.

  • Track and trend quality review results and provide feedback to management.

  • Function as a subject matter expert for discrepancy review, questions from the team, internal stakeholders, and vendors.

  • Train and mentor others by designing and providing training to internal and external teams.

  • May lead teams of analysts assigned to complex projects.

  • The ability to translate complex free-form text comments into cohesive benefit design.

  • Ability to visualize how free-form text comments affect many areas within a plan design.

  • Ability to translate free-form comment text into backend table.

  • Ability to facilitate medium to large-sized meetings to promptly resolve issues amongst multiple internal and external teams until issue resolution and remediation are achieved.

  • Ability to work extended hours, weekends, and/or holidays according to business needs.

  • Provide reporting and analysis to management.

  • Intermediate Excel, Word, Visio, Outlook, PowerPoint, MS Teams, SharePoint, JIRA, and Salesforce knowledge.

Minimum Requirements:

  • Requires a BS/BA degree, 5-7 years of pharmacy business analysis experience which may include the following: pharmacy plan analysis, pharmacy benefit coding, quality review on pharmacy plans, pharmacy operations experience, system capabilities; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

  • In-depth understanding of pharmacy benefit design.

  • Embrace change and can quickly move between different roles and priorities.

  • Ability to thrive with multiple, complex, and timeline- driven work efforts.

  • Understand the urgency of the business and how that translates to personal work ethic and a positive, seamless member experience.

  • Highly organized with precise attention to detail.

  • Ability to travel may be required.

  • Ability to professionally interact with internal and external teams, management, and vendors using strong oral and written communication.

  • Self-motivated and work independently without prompt or follow-up.

  • CPhT is preferred, but not required.

  • Leadership experience.

  • Mentoring experience.

  • Experience pulling and analyzing reports from Excel, systems, and databases.

  • Possess emotional intelligence and the ability to positively impact team culture.

  • Deeply cares about creating an excellent client and member experience.

  • Perform collaboratively with individuals/teams and have a member-oriented mindset.

  • Vendor management experience is preferred, but not required.

  • IngenioRx Spider system experience is preferred, but not required.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

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.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at 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 for assistance.

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