Specialty Pharmacy Contract Manager

Hybrid:
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.

Anticipated

Schedule:

Monday
- Friday 8:00am to 5:00pm EST.

The Specialty Pharmacy Account Manager (Account Service Manager, Payor Contracting) is responsible for providing advanced customer service representation and strategic planning for large accounts.

• Provides strategic planning and account management for larger payor accounts.

• Directs and manages the administration of payor contractual requirements and obligations.

• Assists with the management of the new and renewal implementation process for accounts.

• Interfaces with operations to ensure smooth delivery of services.

• Maintains ongoing payor account relationships at multiple levels throughout the health plan and PBM organizations.

• Makes recommendations for improvements to meet expectations.

• Provides both on-site and off-site customer service, which may include interpreting plan design, researching and resolving phone and written inquiries, resolving claims, benefit, and enrollment issues.

• Prepares and submits contractually required health plan and PBM reports and metrics.

• Program management of payors and payor contracts.

• Requires a BA/BS and a minimum of 3 years of experience managing business operations and/or customer relationship; or any combination of education and experience which would provide an equivalent background.

• Specialty and Infusion Pharmacy experience strongly preferred.

• Payor contract, health plan, and PBM experience preferred.

• Smartsheet and Excel proficiency for payor reporting experience preferred.

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.

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
• 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
• 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…