NFP, an Aon company

Pharmacy Benefits Specialist

NFP, an Aon company

full-time

Posted on:

Location Type: Hybrid

Location: Chesterfield • Montana • United States

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Salary

💰 $57,000 - $75,000 per year

About the role

  • Develop and maintain effective working relationships as liaison between clients, internal teams, and external partners, such PBMs, brokers, and other third party staff.
  • Understand each assigned client’s business model, organizational structure, business goals, pharmacy benefit intent, and forecasted changes.
  • Knowledgeable in the PBM marketplace.
  • Inform leadership of all important activities on client accounts.
  • Present to clients and brokers market reprice analyses, contract terms, and rate dependencies.
  • Research and respond to pharmacy benefit related questions within deadline requirements.
  • Assist in the communication of employee benefits in client enrollment meetings and webinars with the appropriate PBM representation.
  • Assist the client in resolving billing, claim, eligibility, COBRA, and other customer service problems.
  • Partner with PBM teams to resolve problematic benefits issues.
  • Management and execution of client benefit requests, benefit changes, program implementations, new groups, and terminations.
  • Provide annual detailed pharmacy benefit performance reports to clients showing client metrics in comparison to industry benchmarks along with recommendations for plan improvement.
  • Develop robust client relationships to promote client satisfaction, client retention and additional revenue opportunities.
  • Review pharmacy benefit utilization trends and outliers with client as needed.
  • Host clients in the VPS office and/or carrier facilities, as needed.
  • Prepare and provide ad hoc reports as needed.
  • Keep all information on book of business accurate and up to date in the CRM software.
  • Monitor client billing and payments and ensure that proper billing procedures are followed.
  • Participate in seminars and classes for continuing education on industry skills and knowledge.
  • Assist in the development and maintenance of department resources, job aids, training materials, etc.
  • Present a positive image of self and of VPS, in and out of the office, to fellow employees, clients, providers, and the community.
  • Participate in special projects as requested.

Requirements

  • Prefer Bachelor’s degree
  • Associate’s degree or equivalent from two-year college, minimum requirement
  • Prefer three years of PBM related industry experience
  • Knowledge of the Employee Benefits industry, and PBM specifically
  • Excellent research skills
  • Ability to read and interpret industry policies and contract documents, as well as proposals and other documentation and correspondence
  • Ability to respond efficiently and accurately to common inquiries or complaints from customers or carrier
  • Ability to effectively present information to insured clients and their respective carriers
  • Excellent oral and written communication skills and command of the English language
  • Ability to apply basic mathematical concepts such as percentages, adding, subtracting, multiplying and division to required tasks
  • High degree of critical thinking, organizational and decision-making skills
  • Ability to define problems, collect and analyze data, establish facts, and draw valid conclusions
  • High degree of initiative
  • High degree of diligence and attention to detail
  • Ability to function independently with minimal supervision
  • Ability to prioritize multiple projects and meet objectives and deadlines established by supervisor and clients, often with short turnaround times
  • Ability to maintain positive and beneficial relationships with department staff, numerous internal departments, external customers, agents, and subscribers
  • Proficient in MS Excel, Word, Outlook, and PowerPoint
  • Professional telephone skills and e-mail etiquette
  • Ability to comply with company confidentiality requirements as well as with HIPAA and other applicable government regulations.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
pharmacy benefit managementdata analysiscontract interpretationmathematical conceptsreport preparationclient account managementbilling resolutionprogram implementationperformance reportingmarket analysis
Soft Skills
communication skillscritical thinkingorganizational skillsdecision-making skillsinitiativeattention to detailproblem-solvingrelationship managementindependencetime management