Account Service Manager - Payor Contracting- BioPlus Specialty Pharmacy

Elevance Health - Altamonte Springs, FL

Full-time - Mid Level

Altamonte Springs, FL

11-50 employees

Insurance Carriers and Related Activities

About the position

The Account Service Manager - Payor Contracting at BioPlus Specialty Pharmacy is responsible for providing advanced customer service representation and strategic planning for large accounts. This role involves managing payor contractual requirements, ensuring smooth service delivery, and maintaining relationships with payor accounts across various levels within health plans and PBM organizations.

Responsibilities

• Provides strategic planning and account management for larger payor accounts.
• Directs and manages the administration of payor contractual requirements and obligations.
• Manages 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, including interpreting plan design and resolving inquiries.
• Prepares and submits contractually required health plan and PBM reports and metrics.

Requirements

• Requires a BA/BS and a minimum of 3 years of experience managing business operations and/or customer relationship.
• Any combination of education and experience which would provide an equivalent background.

Nice-to-haves

• Pharmacy experience strongly preferred.
• Payor contract, health plan, and PBM experience preferred.
• Smartsheet and Excel proficiency for payor reporting experience preferred.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical benefits
• Dental benefits
• Vision benefits
• Short and long term disability benefits
• 401(k) with matching
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources