More jobs:
Payor Contracting Account Service Manager
Job in
Northern, Floyd County, Kentucky, USA
Listed on 2026-10-07
Listing for:
NOBEL Women
Full Time
position Listed on 2026-10-07
Job specializations:
-
Healthcare
Healthcare / Medical Sales
Job Description & How to Apply Below
Elevance Health seeks a Payor Contracting Account Service Manager for its Bio Plus Specialty Pharmacy. In this role you will manage payor and PBM contract relationships, ensure compliant implementation of specialty pharmacy agreements, and optimize reimbursement and access for complex therapies. You will analyze contract performance, resolve escalated client issues, and partner with pharmacy, clinical, and analytics teams to improve outcomes.
Ideal candidates bring strong healthcare contracting experience, financial acumen, and the ability to lead cross-functional initiatives in a mission-driven, inclusive environment.
- Manage and maintain payor and PBM contracting relationships for Bio Plus Specialty Pharmacy
- Oversee implementation and ongoing administration of specialty pharmacy contracts
- Monitor contract performance, reimbursement, and pricing to drive financial and clinical outcomes
- Analyze data and prepare reports on utilization, margin, and compliance for internal stakeholders
- Resolve escalated client and payor issues, ensuring high service quality and satisfaction
- Collaborate with pharmacy, clinical, finance, and analytics teams to improve contract value and patient access
- Support contract negotiations, renewals, and RFP responses with financial and operational insights
- Ensure adherence to regulatory, legal, and compliance requirements in all contract activities
- Identify opportunities to streamline processes and enhance specialty pharmacy programs
- Contribute to a mission-driven, inclusive culture that supports continuous learning and improvement
- Payor contract management
- PBM and specialty pharmacy operations
- Healthcare reimbursement analysis
- Contract negotiation support
- Account management
- Financial modeling and forecasting
- Regulatory and compliance knowledge (healthcare)
- Data analysis and reporting (Excel/BI tools)
- Cross-functional project management
- Stakeholder and client relationship management
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- 401k
- Bachelor’s degree in business, healthcare administration, finance, or related field
- Preferred: MBA or related master’s degree
- Preferred:
Certified Pharmacy Technician (CPhT) or managed care/contracting certifications
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