Summary of JobManage client relationships and provide clinical and operational expertise related to pharmacy benefits. Work with internal departments (sales, claims, contracting, marketing) to serve accounts effectively and ensure compliance. Partner with Account Manager(s) as account co-owners in many instances. Analyze account and service provision data, developing and presenting quarterly and ad hoc reports to clients. Collaborate with sales and account management on new prospects and current account renewals as relates to the pharmacy benefit. Support sales, marketing, account management and bid support by serving as the main point of contact for clinical client inquiries related to clinical strategies, formulary, drug pipelines, utilization management, clinical edits, clinical and financial trends, PBM and health plan clinical operations functions and issue resolution.
Responsibilities- Provide support to account management teams, focusing on client satisfaction, trend management, clinical strategies, and client retention. Build and maintain strong relationships with key client decision-makers with a particular focus on clinical and executive staff, understanding their healthcare strategies, and making recommendations that align with those strategies.
- Analyze pharmacy claims data to identify trends, providing clinical recommendations, and developing customized clinical business plans and reports.
- Direct Pharmacy Benefit Manager (PBM) in plan design activities.
- Offer expert clinical advice to pharmacy partners, including formulary management, utilization management, and drug trend analysis.
- Support member issue resolution and contribute to process improvement efforts within the team.
- Ensure client contractual requirements are met and participate in contract renewals.
- Interpret and analyze pharmacy claims data to identify trends to present and provide actionable insights.
- Proactively identify opportunities for clinical and operational recommendations and strategies.
- Collaborate with internal teams (sales, business development, technical) to provide clinical expertise and support.
Qualifications- Bachelor of Pharmacy or PharmD
- Registered Pharmacist: Licensed Pharmacist by a US State Board of Pharmacy
- 5 - 8+ years of relevant professional work experience (Required)
- 3 - 5+ years of experience in product management or related field, including pharmacy benefits management, healthcare, or managed care. (Required)
- Account management experience (Preferred)
- Proficiency in analyzing large datasets and interpreting pharmacy claims data (Required)
- Strong analytical and problem-solving skills, with the ability to identify trends and develop data-driven solutions (Required)
- Excellent communication and interpersonal skills with the ability to effectively communicate with diverse audiences, including technical and non-technical stakeholders (Required)
- Excellent presentation skills with the ability to develop and present reports with complex clinical information in an easy-to-understand way to non-clinical client audiences (Required)
- Ability to work in a fast-paced, matrixed environment, able to successfully work across a collaborative, cross-functional team environment (Required)
- Strong proficiency in project management methodologies (Required)
