Account Service Manager, Payor Contracting
About The Position
Account Service Manager, Payor Contracting - BioPlus Specialty Pharmacy Hybrid: 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. Anticipated Schedule: Monday - Friday 8:00am to 5:00pm EST. The Associate Service Manager, Payor Contracting , is responsible for providing advanced customer service representation and strategic planning for large accounts.
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
