Pharmacy Benefits Manager Pricing Strategy Analyst Manager at Elevance Health

Mason, Ohio, United States

Elevance Health Logo
Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Pharmacy BenefitsIndustries

Requirements

  • BA/BS in Finance or related field
  • Minimum of 5 years of experience with a Pharmacy Benefits Manager (PBM), pricing, data analysis; or any combination of education and experience providing an equivalent background

Responsibilities

  • Implements new processes, process improvements, and best practices related to pricing, guarantee monitoring, and ASO pass back activities
  • Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization and pharmacy pricing
  • Creates tools and processes to monitor margin revenue, pricing accuracy, and client retention
  • Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets
  • Implements pricing in the system related to margin
  • Supports the Pharmacy Services team in implementing future revenue, member expansion, and growth capacity
  • Assists with developing pharmacy pricing training to underwriters and updates to underwriting guidelines

Skills

Pricing Strategy
PBM
Guarantee Monitoring
ASO
Revenue Maximization
Metrics Creation
Performance Measures
Margin Monitoring
Pricing Accuracy
Client Retention
Underwriting Guidelines
Process Improvement

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters
1944Year Founded
$309.4MTotal Funding
IPOCompany Stage
Enterprise Software, Social Impact, HealthcareIndustries
10,001+Employees

Benefits

Medical, dental, & vision insurance
401(k) + match
Paid holidays
Paid Time Off
Incentive bonus programs
Stock purchase plan
Life insurance
Wellness Programs
Financial education resources
Adoption & Surrogacy Assistance
Dependent-care Flexible Spending Account (DCFSA)
Parental Leave
Parental Transition Week
Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.
Lawsuit against CMS over MA Star Ratings could lead to financial penalties.
CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.
Acquisition of CareBridge enhances home health services within Carelon division.
Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.
Predictive analytics support early disease detection, aligning with Elevance's whole health approach.
Telehealth expansion offers opportunities to reach more patients remotely.

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