Capital Rx · 3 months ago
Clinical Account Consultant, PBA
United States
Contract
Remote
Mid Level
$145K/yr - $165K/yr
3+ years expCapital Rx is a public benefit corporation delivering full-service pharmacy benefit management solutions. They are seeking a strategic, client-focused Clinical Account Consultant to support clinical functions, ensuring client satisfaction and retention while developing and implementing clinical strategies.
Hospital & Health Care
Responsibilities
Support clinical aspects of implementation for new clients, plans, plan changes, and other clinical plan set-up requirements. This may include gathering client clinical intent and plan requirements, building/coding plans and formularies, conducting peer-review quality control, and reviewing testing and claims output
Actively address all clients’ clinical needs including the management and implementation of custom formularies, clinical criteria, and clinical strategies
Comprehend and effectively explain formulary, benefit, and clinical programs to clients, including intervention components, member and plan experience, book of business experience, and regulatory requirements as it directly pertains to clinical functions
Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for formulary, clinical and plan management strategies
Analyze and interpret pharmacy claims data to identify clinical and plan trends and to offer insights for individual clients and across multiple clients
Communicate drug information to clients and respond to plan-specific clinical inquiries; support resolution of member-specific inquiries
Collaborate with cross-functional teams to support sales initiatives, requests for information (RFI), requests for proposal (RFP), and prospect presentations
Actively attend and contribute to sales meetings and client presentations with a focus on clinical operations and clinical account management
Lead key internal clinical operations initiatives and general business needs/operations, as required
Identify and contribute to clinical process improvement efforts
Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends
Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance
Qualification
Required
Doctor of Pharmacy (PharmD) degree from an accredited institution
Current, unrestricted registered pharmacist license(s)
Relevant experience of 3-5 years in a health plan or pharmacy benefits management (PBM)
Direct account management experience supporting clients across multiple lines of business
Proficient in Microsoft Office Suite with emphasis on Microsoft Excel
Experience working with large datasets and analyzing raw data in Excel
Ability to balance multiple complex projects simultaneously
Exceptional written and verbal communication skills
Flexible, highly organized, and able to shift priorities easily
Attention to detail & commitment to delivering high quality work product
Ability to travel and present to small and large groups
Preferred
Completion of managed care residency, preferred
Prior account management experience of at least three (3) years, preferred
Prior experience with Medicare line of business, preferred
Company
Capital Rx
Capital Rx is now Judi Health! Navigate to our new page here: https://www.linkedin.com/company/judi-health
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
A. J. Loiacono
CEO
Ryan Kelly
CTO
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