Location: Richmond, VA
Company: Elevance Health
of the application of technology to current and future business environments. How you will make an impact: Lead discovery and requirements refinement sessions to uncover customers' business, functional requirements and synthesize requirements to create clear and comprehensive high level and detail business requirements with acceptance criteria Analyzes complex end user needs to determine optimal means of meeting those needs.
Determines specific business application software requirements to address complex business needs. Prioritize multiple efforts including but not limited to mandates, implementations, and operational support across multiple lines of business for both shop and medical
injectable (specialty shop) benefits. Develops requirement traceability metrics enabling traceability to both the project plan and test plan. Partner with cross functional teams - business, programming, and testing staff to ensure requirements will be incorporated into system design and testing.
Utilize Blueprint requirements management tool to document business requirements, obtain stakeholder signoff, and manage requirements through project lifecycle end to end processes ensuring smooth transition and requirements traceability to technical partners. Acts as a resource to users of the software to address questions/issues for multiple prior authorization platforms. Acts as a resource
supporting BPL formulary crosswalk mapping for GRS clients and Medicare Product Launch (MPL).
Provide direction and guidance to team members and serves as an expert for Legal/Executive/Regulatory Decision Special Handling Instructions requirements Provide direction and guidance to team members and serves as an expert of prior authorization requirements including workflows, letters, timers, reporting, and electronic PA processes. Minimum Requirements: Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background.
Knowledge of systems capabilities and business operations is strongly preferred. Preferred Qualifications: PBM and shop knowledge preferred Knowledge of requirement management tool Blueprint strongly preferred Prior authorization experience strongly preferred Experience with multiple membership demographics including Medicaid, Medicare, GRS, Commercial, and MEWA strongly preferred Experience with retail shop and medical injectable (specialty shop) benefits and nuances strongly preferred Experience working with mandates and regulatory business units strongly preferred Knowledge of Agile/Safe practices preferred Knowledge of systems capabilities and business operations is strongly preferred.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions.
Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. 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, interaction, interactionual 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@for assistance.
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, interaction, interactionual 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@for assistance.
Consulting jobs refer to positions within the consulting industry where professionals offer expert advice and strategic solutions to organizations across various sectors. The key feature of these roles includes working with clients to identify challenges, analyze business processes, and develop plans to improve efficiency, increase revenue, or manage change. Consultants often possess specialized knowledge in areas such as management, IT, finance, or human resources. These jobs require strong analytical skills, excellent communication abilities, and the flexibility to adapt to different industries and company cultures. Typically, consulting roles entail project-based work, travel, and direct interaction with senior stakeholders, offering a dynamic and potentially fast-paced career path.
Consulting jobs refer to professions where experts provide strategic advice to companies or individuals. Individuals in these roles analyze challenges, identify improvements, and recommend solutions that drive business efficiency, profitability, and growth. Characterized by problem-solving, project-based engagements, and expertise in specific industries or functions, consultants may work for firms or as independents. This career is marked by its dynamic work environment, frequent travel, and the opportunity for exposure to diverse business scenarios, enabling consultants to rapidly build a broad skill set and professional network.
Consulting jobs refer to positions where professionals provide expert advice to organizations or individuals in a specific area, such as management, technology, finance, or law. Consultants analyze challenges, formulate strategies, and implement solutions to improve client performance. These roles are characterized by project-based work, potential for high-travel, interaction with diverse clients, analytical problem-solving, and often require strong communication skills. Flexibility, adaptability, and the ability to swiftly understand various business contexts are key traits of successful consultants.
Consulting jobs refer to positions where individuals, known as consultants, offer expert advice to organizations or individuals across various industries. These jobs are characterized by problem-solving, strategic thinking, and often require deep expertise in specific areas such as management, technology, finance, or law. Consultants may work for a consulting firm or independently, and their roles often involve project-based work, travel, and client-facing interactions. With a focus on improving client business performance, consultants analyze challenges, propose solutions, and may help implement changes to achieve objectives and drive growth.