Location: This is a hybrid position. Candidates must live within 50 miles of an Elevance Health location.
Build the Possibilities. Make an extraordinary impact.
Responsible for oversight and implementation of the Medicare Pharmacy Benefit and vendor(s) that administer the Medicare pharmacy function for Part B, C and D members.
How you will make an impact:
Manages day-to-day operational pharmacy issues, facilitates resolution of issues and ensures CMS and contract metrics are met.
Identify areas of opportunity to increase efficiency and maximize revenue opportunities and propose improved results based on continuous improvement assessments.
Establishes and builds relationships with account management and leadership teams.
Works with product to develop Medicare products aligned with needs and are compliant with CMS and can be administered by Pharmacy Benefits Managers while being in compliance with contract and performance guarantees.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires a BA/BS in a related field and minimum of 8 years managing business and professional experience in finance, reporting and analysis, project management; including, minimum of 2 years recent Medicare products experience, minimum of 1 year managed care pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Masters degree preferred.
PMP certification preferred.
Full understanding of Pharmacy Benefit Management.
Comprehensive understanding of Medicare benefit types.
Ability to interact with The Centers for Medicare and Medicaid Services (CMS).
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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. 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.
