Strategic Payor Contracts & Account Lead (Hybrid)

Elevance Health; Winston-Salem (NC); Hybrid; USD 85,000 - 115,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Job summary

Elevance Health is seeking a Specialty Pharmacy Account Manager for BioPlus Specialty Pharmacy to provide advanced customer service representation and strategic planning for large payor accounts.

Hybrid role with 1-2 days in office per week; alternate locations considered within commuting distance. You will manage payor contracts, coordinate implementation, and collaborate with operations to ensure service excellence across health plans and PBMs.

Qualifications

• Requires a BA/BS and at least 3 years in business operations and/or customer relationship management.
• Specialty and Infusion Pharmacy experience strongly preferred.
• Payor contracts, health plan and PBM experience preferred.

Responsibilities

• 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.

Skills

Account management

Payor contracting

Excel

Smartsheet

Education

BA/BS degree

Job description

Elevance Health is seeking a Specialty Pharmacy Account Manager for BioPlus Specialty Pharmacy to provide advanced customer service representation and strategic planning for large payor accounts.

Hybrid role with 1-2 days in office per week; alternate locations considered within commuting distance. You will manage payor contracts, coordinate implementation, and collaborate with operations to ensure service excellence across health plans and PBMs.