Business Analyst III

4 days ago

Woodbridge, Connecticut, United States Elevance Health Full time

About the Role:

We are seeking a highly skilled Business Analyst III to join our team at Elevance Health. As a Business Analyst III, you will serve as the liaison between the business and IT, translating complex business needs into application software.

Key Responsibilities:

  • Understand the Pharmacy benefit setup and validate the configuration using test claims/query testing.
  • Validate Formulary, Utilization Management, and Drug List setup using Test Claims/Query testing.
  • Review and provide testing timelines to be included in the project plan.
  • Ensure adherence to committed timelines.
  • Identify and triage defects to closure working with business and adjudication teams.
  • Coordinate and collaborate with cross-functional teams globally.
  • Ensure compliance with mandates and project implementations.
  • Provide the latest status and metrics to the Test lead/project teams.
  • Act as a resource to users of the software to address questions/issues.
  • May provide direction and guidance to team members and serve as an expert for the team.

Requirements:

  • Requires a BA/BS and a minimum of 5 years of business analysis experience; or any combination of education and experience that would provide an equivalent background.
  • 4+ years of experience in the US Healthcare domain (Commercial/Medicaid/Medicare) supporting pharmacy, including claims processing and benefit administration, is strongly preferred.

Preferred Skills and Capabilities:

  • Pharmacy Benefit Management (PBM) knowledge and Clinical formulary and Utilization Management knowledge is strongly preferred.
  • Experience working in Medicaid Line of Business is strongly preferred (Commercial and Medicare experience is a plus).
  • Experience with Data Analysis is preferred.
  • Coordination and collaboration with cross-functional teams is preferred.
  • Experience with Jira, Blue Print, Confluence, and Expertise in MS Excel is strongly preferred.
  • Automation skills (VB Macro/C#) are preferred.

About Elevance Health:

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.

Our Culture:

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.

Benefits:

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.

Hybrid Workforce Strategy:

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

Equal Employment 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.

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