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Program Consultant

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.

CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health.

Hours: Monday - Friday: 9 am - 5 pm EST.

The Program Consultant is responsible for the development and ongoing management of one or more external client facing programs within a business unit. Program consultants typically support business strategies through an integrated portfolio of external client facing projects or initiatives. Primary duties may include, but are not limited to:

How you will make an Impact:

• Manages the development, approval, implementation and compliance of on-going external client facing programs; develops program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day to day business issues.

• Researches applicable subject matter practices and remains aware of industry trends.

• Manages relationships and partners with corporate and regional business areas; coordinates training related to the external client facing program; develops program success measures and performs periodic assessments of external client facing program success.

• Own the end-to-end delivery of FWA reporting and program operations, including the validation, analysis, and distribution of recurring (weekly, monthly, quarterly) and ad hoc reports to internal and external stakeholders.

• Ensure accuracy, integrity, and timeliness of all reporting outputs, proactively identifying and resolving data discrepancies and continuously improving reporting processes through automation and efficiency enhancements.

Minimum Requirements:

• Requires a BA/BS in a related field and minimum of 3 years experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Graduate degree, professional designation related to field or project management experience preferred.

• Advanced Excel proficiency with a focus on speed, accuracy, and automation, including pivot tables, XLOOKUP, Power Query, and macros/VBA; ability to streamline and optimize recurring reporting processes.

• Experience leveraging automation and AI-enabled tools to improve efficiency, reduce manual effort, and accelerate reporting and analysis.

• Strong analytical and critical thinking skills, with the ability to quickly interpret, validate, and synthesize data into actionable insights.

• Demonstrated ability to manage high-volume, deadline-driven work, including recurring reporting cycles and ad hoc requests, while maintaining accuracy and responsiveness.

• Knowledge of healthcare or pharmacy compliance and Fraud, Waste & Abuse (FWA), including experience supporting audits, regulatory requests (e.g., RFIs), and adherence to state and federal requirements.

• Experience coordinating regulatory deliverables, including tracking timelines, managing dependencies, and ensuring compliance with PHI, privacy, and security standards.

• Demonstrated project and program coordination experience, including participation in or ownership of workstreams within cross-functional initiatives; ability to gather requirements, track deliverables, and drive work to completion.

• Proven ability to take ownership and operate with a project management mindset, including prioritization, risk identification, proactive problem-solving, and influencing outcomes without direct authority.

• Client-facing experience with a strong service excellence orientation, including the ability to communicate complex information clearly and manage inquiries with professionalism and responsiveness.

• Experience with case management or CRM systems (e.g., Salesforce), including case triage, prioritization, tracking, and resolution.

• Vendor management and collaboration experience, with the ability to coordinate across internal and external stakeholders to meet program objectives.

• Process improvement mindset, with a track record of identifying inefficiencies, reducing manual work, and enhancing operational workflows.

• Strong written and verbal communication skills, including experience drafting responses for RFIs, RFPs, and client or regulatory communications.

• Experience developing and maintaining policies and procedures, ensuring alignment with regulatory requirements and business practices.

• High attention to detail, accountability, and ownership, particularly when managing sensitive data and time-sensitive deliverables.

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 elevancehealthjobssupport@elevancehealth.com 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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.