Anticipated End Date:

2026-03-02

Position Title:

• Manager, Clinical Patient Access
• Bio Plus Specialty Pharmacy

Job Description: Manager – Clinical Patient Access Location: TX-SAN ANTONIO, 4751 HAMILTON WOLF RD, STE 101

Onsite: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face collaboration, teamwork, and direct engagement. This policy promotes an environment built on in-person interaction, communication, and immediate support.

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.

Shift: This position will operate in standard business hours; 8:00am-5:00pm. Weekends as needed.

Bio Plus Specialty Pharmacy is now part of Carelon Rx (formerly Ingenio Rx), and a proud member of the Elevance Health family of companies. Together, Carelon Rx and Bio Plus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

The Manager – Clinical Patient Access is responsible for performing functions that involve planning for, managing and providing clinical oversight of the Patient Access function, involving initial intake, insurance benefits investigation, and authorization requirements, cultivating an environment of outstanding customer service, as the voice of the company in all interactions with the referral sources and patients.

How you will make an impact:

• Oversee the processing of new patients’ referrals, insurance benefit investigation and verifications, and procurement of authorizations based on clinical criteria provided by the prescriber.

• Train and provide clinical refreshers to the regarding drug therapy, treatment management and disease states as new indications enter the market.

• Participate in pharmaceutical launches, quarterly business reviews and enhanced quality calls with our external partners.

• Resolve clinical escalations presented by either the prescriber, payer, patient or external partner.

• Ensure that the clinical integrity of the prior authorization, appeal and denial process and procedures.

• Monitor results to evaluate compliance with quality and productivity expectations and identify opportunities for improving results.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

• Requires a Doctorate Degree in Pharmacology and minimum of 3 years pharmacy leadership experience; or any combination of education and experience, which would provide an equivalent background.

• Requires a current, valid, active unrestricted Registered Pharmacist license.

Preferred Skills, Capabilities and Experiences:

• Specialty pharmacy experience.

• Prior authorization, claims, and benefit investigation experience.

Job Level:

Manager

Workshift: Job Family:

MED > Licensed/Registered Pharmacist/Pharmacy Technician

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

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.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), 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 elevancehealthjobssupportelevancehealth.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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.