Job Description
Responsibilities:The Associate Pharmacy Benefit Consultant provides pharmacy benefit oversight and Pharmacy Benefit Management (PBM) industry expertise, including plan design, PBM procurement, claims and pricing audits, contractual review, rebate auditing, and guidance on pharmacy matters such as formulary structure and new drugs to market. The Consultant communicates and resolves pharmacy issues for clients, often in coordination with the Health & Welfare Consultant to the client.
Support pharmacy benefit consulting activities, including:
- Preparing, conducting, and analyzing PBM RFPs, including specialty carve-out vendors as requested
- Performing audits of pharmacy benefit management contracts and pharmacy benefits using PBM claims data
- Participating in and supporting clients' financial recovery efforts
- Reviewing PBM pricing, rebates, performance guarantees, plan design, claim eligibility, and other features impacting plan and participant costs
- Advising clients and colleagues on pharmacy matters, emerging market developments, formulary structure, and new drugs to market
Support PBM contract strategy and client issue resolution, including:
- Clearly defining ambiguous contract terms to help achieve more competitive market terms and rates
- Negotiating favorable and transparent contract terms with PBMs
- Reviewing contract terms for compliance with plan requirements and client expectations
- Communicating complex pharmacy benefit issues clearly and resolving client questions in collaboration with the Health & Welfare consulting team
- Building productive relationships with PBMs, vendors, clients, and internal colleagues
Professional and firm development, including:
- Providing guidance and mentorship to colleagues
- Participating in training and professional development to further pharmacy benefit and PBM expertise
- Contributing to Health & Welfare Practice and firm initiatives as needed
- Supporting special projects or assignments related to pharmacy benefits and PBM consulting
Necessary Skills and Attributes:
- Strong PBM industry knowledge, including pharmacy benefit oversight, plan design, PBM procurement, claim auditing, pricing audits, rebate auditing, and contractual review
- Ability to advise clients on pharmacy matters, including formulary structure and new drugs to market
- Entrepreneurial team player who can multitask and work independently
- Engaged, flexible, collaborative, and proactive, with the ability to positively impact strategic and tactical initiatives
- Excellent communication, judgment, creative problem-solving, negotiation, and conflict resolution skills
- Ability to operate as an effective tactical and strategic thinker
- Ability to work in a fast-paced environment, manage multiple priorities, and maintain a high level of accuracy and productivity
- Strong written, verbal, interpersonal, and presentation skills
- Computer / software skills: Strong proficiency with general Office software such as Word, Excel, PowerPoint, Outlook, SharePoint, Teams
Preferred Education and Experience:- Work Experience: Minimum of 5 years of experience in Pharmacy Benefit Management as an Account Executive, Account Manager, or Clinical support, including auditing PBM contracts and pharmacy benefits
- Education: Business, Science, Communication, or Math degree
Location and Travel:- This Pharmacy Benefit Consultant position may be based in Seattle, Washington or Southern California, with flexibility to work remotely much of the time. Some travel is required, up to approximately 30%, including overnight travel to client meetings within the Western U.S.
Total Comp and Benefits:In addition to competitive base pay, this position is eligible for our annual bonus program.
We are proud to offer excellent benefits including a 401k with a 5% company contribution, available medical, dental, vision, life and disability coverage, ESOP, generous time off, and more.
