Initiative Project Leader, CarelonRx PBM Adjudication at Elevance Health in Morristown, New Jersey

Job Description:

CarelonRx is looking to hire an Initiative Project Leader who will be responsible for analyzing, determining, and driving opportunities to standardize, eliminate waste, and improve end-to-end processes across the CarelonRx PBM Claims Adjudication operations org. This position will work in a hybrid way from any US Elevance Health corporate work location.


How you will make an impact:

• Serves as a thought leader regarding improvements of end-to-end CarelonRx Operations Adjudication processes enterprise-wide, with integration points in key business areas.
  
  


• Leads initiatives from assessment through implementation of solutions and ensures that business controls are put in place to monitor the sustainability of process improvements.
  
  


• Builds consensus across organizational functional areas, leads root cause analysis, uncovers trends, contributes to solution definition, and determines best practices both internally and externally.
  
  


• Identifies and resolves tactical and strategic, high-priority organizational and business issues (SWAT team approach.).
  
  


• Leads the development of new enterprise processes, reporting, IT system changes, and business practices.
  
  


• Articulates to the Program Office, Operations Council, and ELT initiative drivers, status, and results.
  
  


• Ensures alignment with other Enterprise initiatives.
  
  

Requires a BA/BS degree in a related field and a minimum of 8 years of professional experience in an operations environment including 7 years of leading and directing large enterprise-wide projects; or any combination of education and experience, which would provide an equivalent background.


Highly preferred skills and experiences:


-Transactional Process Improvement experience and Six Sigma Black Belt certification.


-Project and Program Management experience and certification such as PMP


-Pharmacy Benefits Management experience with back office processes and related technologies to claims adjudication, drug lists, end-to-end user testing, migrations, and architecture.


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. Apply Now