Formulary Business Analyst II CarelonRx

Anticipated End Date:

Position Title:

Formulary Business Analyst II - CarelonRx

Job Description:

Formulary Business Analyst II - 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 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.

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 Business Analyst II will support Clinical Pharmacy Services staff with implementation & maintenance of clinical programs and formularies. Responsible for developing project plans and leading small projects to completion.

How you will make an impact :

• Acts as liaison with clinical team to coordinate timely and accurate completion of various business deliverables.

• Maintains clinical formulary/utilization management (prior authorization step therapy & quantity limits) in web-based formulary management tool Formulary Navigator.

• Support communication of clinical program and formulary changes to members and providers as well as internal stakeholders.

• Support quality assurance processes of clinical programs and formulary strategy

• Support compliance with PBM Accreditation requirements

• Support departmental compliance with state and federal regulations.

• Conducts root cause analysis of processes and issues identifies and makes recommendations for improvements and develops documentation.

• Communicate plans status and issues within the team group or project including business members and management.

Minimum Requirements :

• Requires a BA/BS and minimum of 3 years related business analysis experience or any combination of education and experience which would provide an equivalent background. Knowledge of systems capabilities and business operations is strongly preferred.

Preferred Skills Capabilities and Experiences:

• Experience with Excel skillsstrongly desired.

• PBM or pharmacy experience (e.g. pharmacy technician Formulary Product Manager) strongly preferred.

• Experience with Medicaid formularies preferred.

• Experience with Python SAS or SQL preferred.

• Formulary Software tool (e.g. Formulary Navigator RxFlex) experience strongly preferred.

For URAC accredited areas the following professional competencies apply: Associates in this role are expected to have strong oral written and interpersonal communication skills problem-solving skills facilitation skills and analytical skills.

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.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

BSP > Business Support

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 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.

Required Experience:

IC