Apex Benefits ยท 2 months ago
Director, Clinical Account Management
Indianapolis, IN
Full-time
Hybrid
Lead/Staff, Director/Executive
5+ years expApex Benefits is a recognized leader in the healthcare consulting industry, known for its commitment to client advocacy and cost savings in pharmacy benefits. The Director, Clinical Account Management is responsible for developing and executing strategies for clinical consulting and account management, ensuring the effective execution of client objectives and pharmacy benefit manager contracts.
ConsultingEmployee BenefitsInsurancePredictive AnalyticsRisk Management
Responsibilities
Coordinate meetings, agendas, and follow-up action items related to pharmacy benefit activities
Deliver exceptional customer service, including interpreting plan designs, resolving claims and member issues, and addressing benefit and enrollment inquiries
Conduct routine onsite account visits as needed
Monitor compliance and legislative changes, advising clients and ensuring adherence to regulatory requirements
Lead data assessments, trend analysis, and reporting for clients
Present routine trend reports and annual performance reviews
Plan and execute annual reconciliation and market check processes
Collaborate with clinical and analytics teams to monitor pharmacy claims performance, identifying opportunities to enhance benefits, close clinical gaps, and drive cost savings
Ensure vendors meet client-specific needs and timelines
Interface with PBM operations to resolve issues efficiently
Support implementation of new PBMs, programs, and services
Provide clinical insight during vendor evaluations and the selection of pharmacy benefit managers and consulting solutions
Make informed decisions considering 340B status and pricing implications
Manage custom client-facing formularies
Support Pharmacy & Therapeutics (P&T) initiatives focused on employer benefits
Navigate the financial complexities of owned-entity pharmacies
Advise clients on new-to-market and high-cost drugs, including cost-saving strategies for A/C/J/Q codes and other medical benefit medications
Qualification
Required
Pharmacy degree required; PharmD or Pharmacy Residency preferred
A minimum of 5 years of practical pharmacy experience required or equivalent with a managed care pharmacy residency
Knowledge of current business and industry trends
Superior problem solving, analytical ability, attention to detail and customer service skills
Positive attitude, willingness to learn and interest in working towards team goals
Relationship builder
Excellent organizational and time management skills
Highly developed reasoning and problem-solving skills
Strong verbal communication skills, with ability to present in person with clients and prospects
Self-motivated, with ability to meet deadlines; ability to work productively and proactively
Ability to plan, organize, and work on multiple tasks simultaneously and exercise independent judgement
Proficient in Excel, Word, PowerPoint, and other analytic tools that may be introduced
Abide by all obligations under HIPAA related to Protected Health Information (PHI) and Capable of maintaining confidential information
Preferred
Previous PBM or Pharmacy Benefit experience preferred
Benefits
Competitive benefits
Flexible hybrid work model
Paid time off
A collaborative team environment
Advanced training and development
Company
Apex Benefits
Apex Benefits is an insurance consulting firm that specializes in employee benefits strategy and pharmaceutical benefit consulting.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
John F. Gause
President and CEO | Employee Benefit Strategist
Amber Chittenden
Chief Client Officer
Company data provided by crunchbase