Senior Advisor – Rx Claims, Adjudication

Elevance Health

Senior 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

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

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

business architecturefunctional analysisvalue chain analysisclaims platform configurationstrategic planningIT operationstechnical architectureorganizational managementclaims adjudication

Soft Skills

advisingproblem resolutioncommunicationbridging business and technical discussions

Certifications

BA/BS degree in Information TechnologyBA/BS degree in Computer Science