Member Experience Manager
Capital Rx
Cloud
Clinical Account Manager – PBM
Capital Rx
full-time
Posted on:
Origin: • 🇺🇸 United States • Colorado, New York
Visit company websiteSalary
💰 $140,000 - $160,000 per year
Job Level
Mid-LevelSenior
Tech Stack
Cloud
About the role
- Establish and develop relationships with key client decision-makers, understand their healthcare strategy and goals, determine how Capital Rx can best help them achieve their desired results
- Provide oversight of client account management team with a focus on member and client satisfaction, trend management, and client retention
- Partner with account team members to provide best-in-class member and client service
- Support member issue resolution at client-level
- Identify and contribute to process improvement efforts within the team
- Responsible for management and execution of client contractual requirements
- Responsible for client retention including execution of contract renewals
- Analyze and interpret pharmacy claims data to identify clinical trends and insights for individual clients
- Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for clinical management strategies
- Interpret current pharmacy and healthcare trends and provide proactive recommendations
- Incorporate treatment & practice guidelines, clinical education, and pharmacy pipeline details into client presentations
- Comprehend and effectively explain formulary and clinical programs to clients, including member experience
- Communicate drug information to clients and respond to plan-specific clinical inquiries
- Analyze and evaluate pharmacy benefit reporting and create ad-hoc reports as requested
- Build and manage strong relationships with third-parties who also service our clients
- Support general business needs and operations, as required
- 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
Requirements
- Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution, with record of strong academic performance
- Relevant experience for at least three (3) years in pharmacy - health plan, managed care, or pharmacy benefits management (PBM) experience preferred; or completion of managed care residency
- Prior account management experience preferred
- 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
- Travel estimated not to exceed 25%
