Account Service Manager - Payor Contracting

Elevance Health•Cincinnati, OH

1d•$76,208 - $114,312•Hybrid

About The Position

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve approximately 100M+ people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.

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.