PBM Business Change Manager

PBM Business Change Manager

Hybrid: 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 if candidates reside within a commuting distance from an office.

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.

CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health.

The PBM Business Change Manager is responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals.

How you will make an impact:

• Identifies potential issues, project charge, and scope.
• Leads efforts to identify best practices.
• Identifies impacted parties, business partners, and resources required.
• Develops and designs processes and systems that support business needs.
• Designs methods for integrating function and process.
• Conducts cost/benefit analyses.
• Builds support for business change throughout the business unit.

Minimum Requirements:

• Requires a BA/BS in a related field and minimum of 5 years process or project related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Strong PBM/Pharmacy domain experience, including pharmacy Benefits, Claims Adjudication, Members/Eligibility, Clinical/UM, Networks, Products, and Accumulators.
• Demonstrated experience leading end-to-end UAT, including UAT strategy, test planning, test case development, execution, regression, defect management, business sign-off, and production validation.
• Hands-on experience with pharmacy claim submission and validation, including interpreting benefit configurations and validating claim outcomes against expected business rules.
• Experience reviewing and translating business/functional requirements into comprehensive UAT scenarios, test cases, and acceptance criteria for web-based applications, APIs, and integrated solutions.
• Strong analytical and problem-solving capabilities, including root-cause analysis, defect triage, business impact assessment, and coordination with Product and IT teams through resolution.
• Experience leading onshore/offshore testing resources, including work allocation, execution tracking, dependency management, issue escalation, and consolidation of project status.
• Strong cross-functional stakeholder management and communication skills, with experience partnering with Business, Product, IT, Operations, and SMEs and providing concise status, risk, and release-readiness reporting to senior leadership.
• Hands-on experience with JIRA, Smartsheet, or similar tools for test execution, defect tracking, metrics, dashboards, and project reporting; ability to manage multiple workstreams and drive activities through successful production implementation.
• Working knowledge of GenAI tools to support testing process improvements.
• Experience in successfully developing and managing projects with fairly significant operating budget and knowledge of process redesign.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $85,680 to $141,372.

Location(s): Illinois, Virginia.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: BSP > Business Support

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.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words the job is posted until 3/13, not through 3/13.