Specialty Pharmacy Account Manager

Elevance Health • Durham, NC

2d • Hybrid

About The Position

The Specialty Pharmacy Account Manager (Account Service Manager, Payor Contracting) at BioPlus Specialty Pharmacy provides advanced customer service representation and strategic planning for large accounts. The role manages payor relationships and contractual requirements, supports implementation of new and renewed accounts, and coordinates with operations to ensure services are delivered smoothly. It also provides on-site and off-site customer service, handles plan design interpretation and account inquiries, and prepares required reports and metrics.

This is a hybrid role requiring associates to work in the office 1–2 days per week. Candidates must live within a reasonable commuting distance of a listed office unless an accommodation is granted as required by law. The anticipated schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. Eastern Time.

Requirements

• BA/BS degree and a minimum of 3 years of experience managing business operations and/or customer relationships, or an equivalent combination of education and experience.
• Must be within a reasonable commuting distance of a posting location for the hybrid arrangement, unless an accommodation is granted as required by law.

Nice To Haves

• Specialty and infusion pharmacy experience.
• Payor contract, health plan, and PBM experience.
• Smartsheet and Excel proficiency for payor reporting.

Responsibilities

• Provide strategic planning and account management for larger payor accounts.
• Direct and manage administration of payor contractual requirements and obligations.
• Assist with management of the new and renewal implementation process for accounts.
• Interface with operations to ensure smooth delivery of services.
• Maintain payor account relationships at multiple levels throughout health plan and PBM organizations.
• Recommend improvements to meet expectations.
• Provide on-site and off-site customer service, including interpreting plan design, researching and resolving phone and written inquiries, and resolving claims, benefit, and enrollment issues.
• Prepare and submit contractually required health plan and PBM reports and metrics.
• Manage payors and payor contracts through program management.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs, unless covered by a collective bargaining agreement
• Medical benefits
• Dental benefits
• Vision benefits
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level