PBM Contract Manager at Elevance Health

Norfolk, Virginia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

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

Responsibilities

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

Skills

Key technologies and capabilities for this role

PBMContract ManagementRFPContract NegotiationComplianceVersion ControlInsurance ContractsHMOSelf-Funded BenefitsWorkflow CoordinationQuality ControlContract Drafting

Questions & Answers

Common questions about this position

What is the work arrangement for this role?

This role requires associates to be in-office 1-2 days per week to foster collaboration, while providing flexibility for virtual work. Candidates must reside within a reasonable commuting distance from an office location, unless an accommodation is granted.

What are the minimum education and experience requirements?

The role requires a BA/BS in a related field and a minimum of 6 years of related experience, or any combination of education and experience that provides an equivalent background.

What salary or compensation does this position offer?

This information is not specified in the job description.

What are some preferred skills for this role?

Paralegal experience is preferred for this position.

What experience makes a strong candidate for this PBM Contract Manager role?

Strong candidates will have a BA/BS and 6+ years of related experience in contract management, particularly overseeing full contract lifecycles, ensuring compliance, and collaborating with stakeholders on PBM agreements. Paralegal background and experience with negotiation, approvals, and version control are preferred.

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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