Specialty Pharmacy Payor Relations Manager

Elevance Health; Winston-Salem (NC); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Elevance Health’s Specialty Pharmacy team seeks a results-driven Specialty Pharmacy Account Manager to support BioPlus Specialty Pharmacy accounts. You will lead strategic planning and manage large payor relationships, ensuring seamless contract administration and timely implementation for new and renewing accounts.

This hybrid role requires 1–2 days in-office weekly and collaboration with operations to optimize service delivery while delivering detailed reports to health plans and PBMs.

Qualifications

• BA/BS with at least 3 years of experience in business operations and/or customer relationship management.
• Preferred: Specialty and Infusion Pharmacy exposure.
• Payor contract, health plan and PBM experience is a plus.
• Smartsheet and Excel proficiency for payor reporting is preferred.

Responsibilities

• Provides strategic planning and account management for large payor accounts.
• Directs and manages administration of payor contractual requirements and obligations.
• Assists with new and renewal implementation processes for accounts.
• Interfaces with operations to ensure smooth delivery of services.
• Maintains ongoing payor account relationships at multiple levels within health plans and PBMs.
• Makes recommendations to improve performance and meet expectations.
• Provides on-site and off-site customer service, including plan design interpretation, inquiries resolution, and enrollment issues.
• Prepares and submits required health plan and PBM reports and metrics.
• Manages payors and payor contracts.

Job description

Elevance Health’s Specialty Pharmacy team seeks a results-driven Specialty Pharmacy Account Manager to support BioPlus Specialty Pharmacy accounts. You will lead strategic planning and manage large payor relationships, ensuring seamless contract administration and timely implementation for new and renewing accounts.

This hybrid role requires 1–2 days in-office weekly and collaboration with operations to optimize service delivery while delivering detailed reports to health plans and PBMs.