PBM Contract Manager

Elevance Health-posted 10 days ago
Full-time • Mid Level
Hybrid • West Des Moines, IA
5,001-10,000 employees
Insurance Carriers and Related Activities
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PBM Contract Manager Location: 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. The PBM Contract Manager is responsible for managing the full life cycle of Pharmacy Benefit Management (PBM) contracts from RFP through client contract execution. This includes oversight of the contract approval process, ensuring compliance, version control, and supporting the negotiation and execution of standard and less complex agreements. How You Will Make an Impact

  • Oversee the PBM contract approval process, ensuring version control, timely execution, and policy compliance.
  • Evaluate contracts for compliance with insurance, HMO, and self-funded benefit requirements, and with internal policies and procedures.
  • Coordinate and monitor workflow, allocate resources, establish priorities, and implement standardization for efficiency.
  • Provide quality control; interpret contract requests, and research and resolve account or template-related inquiries.
  • Serve as a consultative resource to sales and internal business clients on standardized or less complex contract language and negotiation options.
  • Manage the entire contracting process, including drafting contracts, meeting internal deadlines, securing approvals, and overseeing execution.
  • Draft and assist in the negotiation of new agreements, renewals, amendments, and other contract forms.
  • Communicate contract deliverables to operational teams and ensure all necessary internal approvals are obtained.
  • Collaborate with internal stakeholders, external clients, and consultants to support PBM contracting initiatives.
  • Review RFP responses to ensure compliance with corporate standards and market competitiveness.
  • Maintain and update contract templates; manage approval workflows for standard and exception-based contract language.
  • Conduct general research and support administrative tasks or special projects related to contracts and systems improvements.
  • Maintain organized records of executed contracts and supporting documentation.
  • Provide oversight and mentorship to PBM Contract Consultant team members.
  • Requires a BA/BS in a related field and a minimum of 6 years of related experience; or any combination of education and experience, which would provide an equivalent background.
  • Paralegal certification and/or training in the legal field and/or healthcare contracting experience.
  • Strong contract negotiation skills.
  • Proven ability to manage multiple priorities with attention to detail and meet tight deadlines.
  • Excellent written and verbal communication skills.
  • Ability to research, analyze, and clearly summarize complex information.
  • Strong documentation and organizational skills.
  • Proficiency in using Artificial Intelligence tools.
  • Demonstrated leadership and interpersonal skills, with the ability to work independently and as part of a team.
  • We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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