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Senior Advisor – Rx Claims, Adjudication
Elevance HealthSenior Advisor responsible for pharmacy claims adjudication and business architecture at Elevance Health. Driving business blueprint completion and advising on claims platform configuration.
Posted 6/17/2026full-timeMason • Connecticut, Minnesota, Ohio, Virginia • 🇺🇸 United StatesSenior💰 $126,720 - $190,080 per yearWebsite
ATS Keywords
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Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
business architecturefunctional analysisvalue chain analysisclaims platform configurationstrategic planningIT operationstechnical architectureorganizational managementclaims adjudication
Soft Skills
advisingproblem resolutioncommunicationbridging business and technical discussions
Certifications & Qualifications
BA/BS degree in Information TechnologyBA/BS degree in Computer Science
Industry Keywords
PBM operationspayer workflowsclaims adjudication expertise
About the role
Key responsibilities & impact- Drive and complete the Business Architecture portion of business blueprints
- Establish guiding principles and define capabilities
- Perform functional analysis/definition and analyze/document the value chain
- Assess organizational impacts and identify adjudication defects
- Support resolution of high-impact claims issues and escalations
- Advise on claims platform configuration
Requirements
What you’ll need- BA/BS degree in Information Technology, Computer Science or related field of study
- Minimum of 5 years of experience in business analyst and strategic planning, IT operations, IT leadership strategic and technical architecture
- Minimum of 3 years in organizational management related to information architecture
- Deep claims adjudication expertise
- Understanding of PBM operations, payer workflows, and claims adjudication platforms
- Ability to bridge business and technical discussions effectively
Benefits
Comp & perks- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Paid holidays
- Paid Time Off
- Medical, dental, vision benefits
- Short and long term disability benefits
- Wellness programs
- Financial education resources