Clinical Account Manager

Summary

The Clinical Account Manager is responsible for the clinical provisions of assigned accounts including assisting in the presentation, set-up and implementation of clinical programs; help with plan and participant communications where applicable; working with the Account Manager to provide the customer with measurable clinical program outcomes. The Clinical Account Manager will assist in providing plan reviews that describe the customer’s specific benefit utilization footprint, observations, outliers, and proactive steps to address outliers as needed. Service includes maintaining strong internal and external relations through proactive contact, plan management, service reviews and timely and accurate response to Account Management and Client requests. Other projects as assigned by management.

Essential Duties and Responsibilities

• Maintains a high-level contact with Account Managers in support of WellDyne clients and/or the client’s representatives (i.e. third party administrators, human resources personnel, brokers, etc.), including traveling to meet in person as appropriate.
• Provides superior clinical consultation and account management with focus on client retention/satisfaction and trend management.
• Conducts utilization and cost analyses, drug utilization reviews and analyses, formulary management, and serves as a drug information resource.
• Designs and interprets client utilization reports and presents benefit changes or utilization management to assist clients in maximizing the value of their pharmacy benefit.
• Provides education for clients, pharmacists, members, and physicians, including one-on-one physician visits and implementation of educational programs.
• Provides sales support including giving presentations to prospective clients or assisting sales with responses to requests for proposals (RFP's).
• Team and relationship focused, with excellent interpersonal skills for dealing with clients, peers, internal departments, and senior management.
• Excellent written communication and documentation skills.
• Participates in ongoing participation in industry and product knowledge including national and PBM trends/ benchmarks, company product offerings, PBM pricing, PBM capabilities.
• Performs other duties as assigned to meet corporate objectives.

Education and Experience

• Bachelor’s Degree in Pharmacy or Doctor of Pharmacy (PharmD),
• RPh license active and in good standing
• 2+ years’ experience in managed care programs (Pharmacy Benefits Management; self-funded or health plan).
• 1+ year of experience working with pharmacy data.
• 1+ year of experience giving presentations required.
• 1+ year of experience working in a client facing role (I.E. working with vendors, account management role, business partners, etc).
• 1+ year of experience managing multiple projects required.
• Proficiency in Microsoft Office applications, particularly Excel as well as reporting tools such as Tableau
• Must have expert level understanding of the data elements of a pharmacy claim that is adjudicated from a pharmacy to a payer
• Experience with Utilization Management preferred.

• Must have expert level knowledge of all desktop computer applications in MS Office suite, particularly Excel.
• Ability to adapt and be flexible in a variety of situations.
• Must be able to work independently as well as support, contribute and team lead.
• Follows all policies and procedures related to the job.
• Advanced project planning skills; must have the ability to manage multiple projects to successful, timely conclusion.
• Ability to communicate with all levels of people in a manner which illustrates superior professionalism including speaking in front of groups of people; ability to communicate clinical information at both a layperson and peer level.
• Ability to understand individual client needs and incorporate programs to meet those needs from multiple perspectives: clinical, member disruption and financial perspectives.
• Ability to analyze, interpret and organize clinical and financial information in a clear and concise manner.

Work Environment / Physical Demands

This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.

EOE M/F/D/V