Account Service Manager, Payor Contracting
About The Position
The Associate Service Manager, Payor Contracting, is responsible for providing advanced customer service representation and strategic planning for large accounts. 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.
Requirements
- 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.
Nice To Haves
- Specialty and Infusion Pharmacy experience strongly preferred.
- Payor contract, health plan, and PBM experience preferred.
- Smartsheet and Excel proficiency for payor reporting 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.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
