Clinical Account Consultant, PBM

Judi Health

$140K — $160K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Pharmacy (PharmD) degree from an accredited institution.
  • Active pharmacist license or ability to obtain/maintain licensure.
  • 3-5 years of experience in PBM, managed care, or health plans.
  • Strong clinical knowledge of formulary management and utilization management.
  • Experience in analyzing pharmacy claims data for actionable insights.
  • Ability to convey complex clinical concepts to diverse audiences.
  • Strong written and verbal communication skills.

Responsibilities

  • Analyze pharmacy claims and drug trend data for insights.
  • Translate treatment guidelines and market trends into client strategy.
  • Operationalize clinical recommendations with internal teams.
  • Review and support execution of disruption analyses and clinical materials.
  • Prepare client-ready clinical content for various business reviews.
  • Coordinate with internal teams to align clinical and operational strategies.
  • Support additional business and team needs as required.

Benefits

  • Flexible working environment with a focus on clinical expertise.
  • Opportunities for professional development and continuous learning.
  • Collaborative work culture involving cross-functional teams.
  • Engagement with clients to enhance pharmacy benefits and outcomes.
Full Job Description
Position Summary:

The Clinical Account Consultant (CAC) is a clinical subject matter expert behind a portfolio of pharmacy benefit
management clients. Responsibilities include turning complex claims data, clinical guidelines, and market shifts into
clear, data-driven recommendations. This role partners closely with Account Executives and internal teams to
improve member outcomes and pharmacy benefit performance across the client lifecycle.

Position Responsibilities:

Shape Clinical Strategy
  • Analyze pharmacy claims, utilization, and drug trend data to surface insights and build evidence-based
    recommendations across formulary, utilization management, specialty, and clinical programs.
  • Translate treatment guidelines, pipeline developments, and market trends into client strategy and assess
    its clinical impact.

Drive Clinical Program Execution & Client Delivery
  • Operationalize approved recommendations with internal teams so clinical intent is accurately reflected in
    formulary changes, utilization management initiatives, and other pharmacy benefit enhancements.
  • Review disruption analyses, clinical readiness materials, and post-go-live outputs to support accurate
    execution and a strong client/member experience.
  • Build client-ready clinical content for quarterly business reviews, strategic reviews, renewals, finalist
    presentations, and other client needs - then present findings and field clinical questions directly.


Build to Scale
  • Partner with Account Executives, analytics, operations, product, and other internal teams to align clinical
    strategy with operational execution and platform capabilities.
  • Contribute to the development of standardized clinical tools, templates, and best practices that raise
    quality, efficiency, and consistency across the team.

Additional Responsibilities
  • Support general business and team needs, as required.
  • Certain times of year may require meeting participation, testing, claims review, or other support outside of
    standard business hours, including weekends.


Required Qualifications:
  • Doctor of Pharmacy (PharmD) degree from an accredited institution.
  • Active pharmacist license, or ability to obtain/maintain licensure as required.
  • 3-5 years of experience in PBM, managed care, or health plan environments.
  • Strong clinical knowledge of formulary management, utilization management, clinical programs, and
    pharmacy trend analysis.
  • Experience analyzing pharmacy claims data and translating findings into actionable clinical
    recommendations.
  • Ability to explain complex clinical concepts clearly to both clinical and non-clinical audiences.
  • Strong written and verbal communication skills.
  • Highly organized and able to manage multiple priorities in a fast-paced, cross-functional environment.
  • Proficiency in Microsoft Office Suite, including Excel, and experience working with large data sets.
  • Ability to travel and present to small and large groups; travel is estimated not to exceed 25%.


Preferred Qualifications
  • Experience supporting formulary strategies, utilization management programs, or specialty pharmacy
    initiatives.
  • Experience contributing to client-facing clinical presentations and strategic recommendations.
  • Familiarity with implementation support related to formulary strategy, disruption review, or clinically
    driven benefit setup.
  • Experience working in a highly collaborative, matrixed environment.


New York, NY Salary Range

$140,000-$160,000 USD

Denver, CO Salary Range

$140,000-$160,000 USD

Charlotte, NC Salary Range

$140,000-$160,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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