PBM Contract Manager

PBM Contract Manager

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.

Minimum Requirements

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.

Preferred Skills, Capabilities and Experiences :

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs, 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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact support@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.