PBM Pricing Strategy Analyst Manager - CarelonRx

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. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.

• 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.

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.

The PBM Pricing Strategy Analyst Manager will be responsible for Pharmacy Services pricing and Administrative Services Only (ASO) support functions, analyzing complex datasets, developing insights into specialty drug utilization, and managing client relationships to ensure the highest standards of service and satisfaction.

How you will make an impact:

• Analyze pharmacy data to identify trends, patterns, and opportunities for optimizing drug utilization and client outcomes.
• Collaborate with clinical teams to integrate data insights into practice, enhancing treatment protocols and therapeutic outcomes.
• Implements new processes, process improvements, and best practices related to pricing, guarantee monitoring, and ASO pass back activities
• Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization and pharmacy pricing
• Creates tools and processes to monitor margin revenue, pricing accuracy, and client retention
• Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets
• Implements pricing in the system related to margin
• Supports the Pharmacy Services team in implementing future revenue, member expansion and growth capacity
• Assists with developing pharmacy pricing training to underwriters and updates to underwriting guidelines

Minimum Requirements:

• Requires a BA/BS in Finance or related field and a minimum of 5 years of experience with a Pharmacy Benefits Manage (PBM), pricing, data analysis; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• MBA strongly preferred.
• Proficiency in advanced data analytics techniques, with a focus on enhancing operational efficiencies within specialty drug programs.
• Expertise in analyzing pharmacy data to discern trends, patterns, and opportunities for optimizing drug utilization and improving client outcomes.
• Strong ability to collaborate with clinical teams to apply data insights effectively, enhancing treatment protocols and therapeutic outcomes.
• Experienced in managing client relationships, acting as a primary contact to address client needs, provide insights, and ensure client satisfaction.
• Skilled in developing and maintaining dashboards and reporting tools to monitor pharmacy performance, patient outcomes, and client metrics.
• Capability to provide strategic recommendations to senior management, utilizing data-driven insights to improve pharmacy services and business strategies.
• Thorough understanding of data integrity procedures and compliance with healthcare regulations and standards.
• Commitment to staying updated on new developments in data analytics, specialty pharmacy trends, and clinical practices.

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 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, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.