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Clinical Account Consultant, PBA

2 hours, 47 minutes ago
United States
Full-time
Mid Level
Account Manager
Sales and Business Development
Apply Now
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017
View All Jobs 17

Description

  • Support clinical implementation for new clients, plan changes, and clinical plan set-up, including gathering requirements, building and coding plans and formularies, and reviewing testing and claims output.
  • Manage client clinical needs by implementing custom formularies, clinical criteria, and clinical strategies.
  • Explain formulary, benefit, and clinical programs to clients and clarify regulatory requirements and member and plan impacts.
  • Meet with clients to review pharmacy data, discuss clinical trends, and recommend formulary, clinical, and plan management strategies.
  • Analyze pharmacy claims data to identify clinical and plan trends and provide insights for individual clients and across the client base.
  • Communicate drug information and respond to client clinical inquiries, including support for member-specific issues.
  • Collaborate with cross-functional teams on sales initiatives, RFIs, RFPs, and prospect presentations.
  • Participate in sales meetings and client presentations with a focus on clinical operations and account management.
  • Lead internal clinical operations initiatives and contribute to broader business operations as needed.
  • Identify and support clinical process improvement efforts.

Requirements

  • Doctor of Pharmacy (PharmD) degree from an accredited institution.
  • Current, unrestricted registered pharmacist license(s).
  • 3-5 years of relevant experience in a health plan or pharmacy benefits management (PBM) setting.
  • Direct account management experience supporting clients across multiple lines of business.
  • Proficiency in Microsoft Office Suite, especially Microsoft Excel.
  • Experience working with large datasets and analyzing raw data in Excel.
  • Ability to manage multiple complex projects simultaneously.
  • Exceptional written and verbal communication skills.
  • Highly organized, flexible, and able to shift priorities easily.
  • Strong attention to detail and commitment to high-quality work.
  • Ability to travel and present to small and large groups.
  • Managed care residency completion, preferred.
  • At least 3 years of prior account management experience, preferred.
  • Prior Medicare line of business experience, preferred.

Benefits

  • Salary range of $145,000 to $165,000 USD.
  • Opportunity to work at an enterprise health technology company serving employers, TPAs, and health plans.
  • Flexible position structure that may include occasional after-hours or weekend work when needed.
  • Commitment to equal employment opportunity and a diverse, inclusive workplace.
  • Privacy and data-retention practices outlined for applicant consideration.

Interested in this position?

Apply directly on the company website

Apply Now

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