Specialty Account Executive - BioPlus Specialty Pharmacy

Elevance Health•Durham, NC

4d•Hybrid

About The Position

The Specialty Account Manager is responsible for overseeing account and client management, building relationships with clients, ensuring programs support contract requirements, reviewing and implementing changes to reverse adverse trends, supporting payer credentialing activities, and ensuring continuity of service.

Requirements

Requires associate degree and a minimum of 3 years of experience in specialty pharmacy, retail pharmacy, or retail clinics and 2 years of pay program experience; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

BA/BS preferred.

Responsibilities

Manage relationships with external partners and clients, ensuring continuity of service.
Serve as primary coordinator and liaison for largest accounts, handling client-related matters and providing feedback to leaders.
Collaborate on client services, sales, billing, finance, and internal operational processes to meet performance requirements.
Define and measure performance standards/guarantees, develop scorecards, analyze and report progress, and implement changes as needed.
Prepare and participate in payor audits for assigned clients, offering support in areas such as operations and performance guarantees, and recommending improvements.
Address performance and process improvements across the organization to comply with agreements.
Coordinate accurate and timely credentialing activities for health plans and pharmacy benefit managers (PBMs), partnering with internal and external stakeholders to support end-to-end credentialing processes.
Act as a liaison between internal payer contracting and operational teams to resolve credentialing-related issues and ensure timely completion of required documentation.
Utilize internal systems and reporting tools to research issues, monitor credentialing status, and support compliance activities, including accreditation and regulatory requirements.