Account Manager
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Job Description
Account Manager guiding self-insured clients through pharmacy benefit solutions and maximizing value through consultation and analysis.
Responsibilities:
- Serve as the trusted advisor to employer benefits leaders, HR teams, and benefit consultants/brokers
- Lead all client interactions, including regular strategy meetings, annual renewal negotiations, and quarterly performance reviews
- Proactively identify and address client needs, providing consultative recommendations on formulary management, clinical programs, network strategies, and cost-containment opportunities
- Oversee all aspects of benefit implementation and ongoing maintenance, ensuring benefit updates and contractual deliverables are executed accurately and on time
- Manage the full issue resolution lifecycle, serving as the internal advocate for the client
- Ensure strict compliance with all contractual terms, service level agreements (SLAs), and regulatory requirements (e.g., HIPAA, Medicare Part D/CMS)
- Analyze complex pharmacy claims data, utilization reports, and financial metrics to identify key trends, cost drivers, and opportunities for clinical and financial optimization
Requirements:
- Bachelor's degree in Business, Healthcare Administration, Pharmacy, or a related field
- 3+ years of experience in account management, client service, or consulting within the Pharmacy Benefit Management (PBM) or Managed Care industry
- Deep understanding of pharmacy benefit concepts, including formulary management, clinical programs (PA, Step Therapy, QL), rebate aggregation, and the competitive PBM landscape
- Strong proficiency in analyzing and interpreting pharmacy claims data, financial reports, and utilization trends
- Expert-level skills in Microsoft Office Suite, Google Workspace, particularly Excel/Sheets (pivot tables, VLOOKUP) and PowerPoint/Slides
- Familiarity with PBM claims processing systems (e.g., RxClaim) is a plus.
Benefits:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
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