Manager, Clinical Patient Access - BioPlus Specialty Pharmacy

Anticipated End Date:

2026-03-02

Position Title:

Manager, Clinical Patient Access - BioPlus 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.

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus 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,