Blue Cross and Blue Shield Association

Director, Trade Client Relations

US-Anywhere
+ 9 other locationsRemote
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Pharmacy degree and Pharm D. preferred
  • 5-7 years in healthcare, PBM, utilization management, or pharmaceutical contracting
  • Excellent verbal and written presentation skills
  • Ability to build relationships at all organizational levels
  • Practical application of clinical data for financial value
  • Strong business acumen with advanced Excel and PowerPoint skills

Responsibilities

  • Consult with Client Relations team on Trade inquiries and initiatives
  • Convey messaging about rebate strategies to health plan participants
  • Manage clinical policies to ensure compliance with manufacturer contracts
  • Collaborate with Analytics Team on drug trends and utilization data
  • Serve as primary contact for Participant questions regarding Trade initiatives
  • Liaise with Clinical team for policy requirements review

Benefits

  • Paid time off and 11 holidays
  • Medical, dental, and vision insurance
  • Generous 401(k) matching
  • Lifestyle spending account
  • Comprehensive benefits package
Full Job Description
The Trade Client Strategy Director liaises with Synergie Participants and manages clinical policies to comply with manufacturer contracts, implements Trade strategies and initiatives, and collaborates with and supports Synergie’s Client Relations team for Trade related inquiries. This includes medical and pharmacy drug policies, cross benefit management, and rebate qualification for manufacturer contracts. This position will establish and maintain cross functional partnerships with internal teams to drive the identification, development and successful execution of Synergie’s rebate programs. This position will be the primary Trade point of contact for Synergie’s Participant facing activities and will support clinical decision making at the Participant level to comply with manufacturer contracts.

Primary Job Functions

  • Consult with Client Relations team on Trade related inquiries, initiatives, and opportunity pull through with Participants

  • Understands downstream impact of rebate and formulary strategy and can convey appropriate messaging to health plan participants for adoption of said strategies and policies

  • Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation

  • Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and understanding how to align terms and conditions and translate into UM policy and criteria

  • Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract compliance

  • Collaborate and support Client Relations team for Trade related inquiries from Participants

Partner with the following stakeholders:

  • Analytics Team – Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies

  • Client Relations – Serve as Trade’s primary point of contact for all Participant questions on Trade initiatives and manufacturer contracts and escalate issues as needed to Trade’s leadership

  • Clinical Team – Liaise with Clinical team to review clinical data and policy requirements as needed

  • Invoicing Team – Maintain current library of Participant medical and pharmacy policies and support Invoicing team with manufacturer inquiries regarding clinical policies

  • Product Team – Provide medical policy support for manufacturer related contracts including, but not limited to, cell and gene therapies and other outcomes programs ​

Education, Experience, and Certification

  • Pharmacy degree and Pharm D. preferred

  • 5-7 years of related work experience in healthcare, pharmacy benefit management (PBM), utilization management, pharmaceutical contracting, client relations, or analytical contracting

  • Must be eligible to work in the United States without need for work visa or residency sponsorship

  • Excellent verbal and written presentation skills

  • Ability to establish rapport and build relationships at all levels within an organization

  • Practical application of clinical data to drive financial value

  • Strong business and financial acumen, with advanced proficiency in Excel and PowerPoint

Knowledge, Skills, and Abilities

  • Pharmacy residency training or equivalent experience

  • Experience within the PBM industry, Medicaid, Medicare, and health plans

  • Experience with contract language and risk mitigation concepts

Travel Requirements: Up to 10% of the time.

Work is generally performed in a remote setting.

#LI-Remote

$155,000.00 - $175,000.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the hiring range andthis hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.This job is also eligible for annual bonusincentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays,medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

About Blue Cross and Blue Shield Association

The Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while Blue Shield emerged in 1939 and the Blue Shield Association was created in 1948. The Blue Cross Blue Shield Association is headquartered in Chicago and has offices in Washington, D.C. The association provides health insurance products and services to more than 106 million Americans.
Learn more about Blue Cross and Blue Shield Association
Size
1,000 employees
Industry
Founded
1929

Similar Jobs

More Jobs at Blue Cross and Blue Shield Association

More Healthcare Jobs

Find similar Director, Trade Client Relations jobs: