Director, Human Insights
Kraft Heinz
Invision
Director, Trade Client Strategy
Blue Cross Blue Shield Association
full-time
Posted on:
Location Type: Remote
Location: Remote • Illinois, New York, Oregon, Virginia • 🇺🇸 United States
Visit company websiteSalary
💰 $155,000 - $175,000 per year
Job Level
Lead
About the role
- 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
Requirements
- 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
- 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.
Benefits
- paid time off
- 11 holidays
- medical/dental/vision insurance
- generous 401(k) matching
- lifestyle spending account
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
pharmacy degreePharm Dclinical data analysisutilization managementpharmaceutical contractingcontract language interpretationfinancial acumenrisk mitigationExcelPowerPoint
Soft skills
verbal communicationwritten communicationrelationship buildingcollaborationpresentation skills
Certifications
pharmacy residency training
