Business Consultant

Hybrid Work Arrangement

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. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless accommodation is granted as required by law.

About the role

The Business Consultant is responsible for translating moderately complex and varied business needs into application software requirements. The role requires full technical knowledge of most phases of systems and business analysis and the ability to consider the business implications of applying technology to current and future business environments.

How You Will Make An Impact

• May lead teams of analysts assigned to complex projects.
• Determines specific business application software requirements to address complex and varied business needs.
• Analyzes and designs solutions to address complex and varied business needs.
• Consults with business partners concerning application and implementation of technology.
• Leads restitution reviews and operational investigations to assess member, client, and financial impacts resulting from process, system, or configuration issues.
• Conducts complex business and claims data analyses to quantify impact, identify trends, and support remediation recommendations.
• Partners with cross-functional teams including Operations, Product, Technology, Finance, Compliance, and Client Services to evaluate risks and develop corrective actions.
• Facilitates root cause analysis efforts and drives process improvements that strengthen operational controls and prevent future issues.
• Develops impact assessment methodologies, business cases, and executive-level reporting to support decision making.
• Supports strategic PBM Operations initiatives by evaluating operational impacts, implementation risks, and business performance outcomes.
• Prepares and presents findings, recommendations, and status updates to leadership and key stakeholders.
• Maintains documentation and governance artifacts to support compliance, audit, and contractual obligations.

Minimum Requirements

Requires a BA/BS and minimum of 8 years of business analysis experience, which should include analysis and project management; or any combination of education and experience that provides an equivalent background.

Preferred Skills, Capabilities and Experiences

• Knowledge of systems capabilities and business operations is strongly preferred.
• Knowledge of PBM operations, pharmacy claims adjudication, and benefit configuration is preferred.
• Experience with impact analysis, operational risk assessments, and root cause investigations is preferred.
• Strong analytical and problem-solving skills with experience working with large datasets is preferred.
• Proficiency in Excel, SQL, Power BI, or similar reporting and analytics tools is preferred.
• Ability to translate complex findings into actionable business recommendations is preferred.
• Strong communication and presentation skills, including executive-level reporting is preferred.
• Experience leading cross-functional initiatives and driving process improvements is preferred.
• Healthcare, PBM, compliance, or operational consulting experience is preferred.

Pay

For candidates working in person or virtually in Virginia, the salary range for this position is $87,680 to $131,520.