Associate Pharmacy Benefit Consultant

Rael & Letson•San Diego, CA

2d•Hybrid

About The Position

The Associate Pharmacy Benefit Consultant provides pharmacy benefit oversight and Pharmacy Benefit Management (PBM) industry expertise, including plan design, PBM procurement, claims and pricing audits, contractual review, rebate auditing, and guidance on pharmacy matters such as formulary structure and new drugs to market. The Consultant communicates and resolves pharmacy issues for clients, often in coordination with the Health & Welfare Consultant to the client.

Requirements

Strong PBM industry knowledge, including pharmacy benefit oversight, plan design, PBM procurement, claim auditing, pricing audits, rebate auditing, and contractual review
Ability to advise clients on pharmacy matters, including formulary structure and new drugs to market
Entrepreneurial team player who can multitask and work independently
Engaged, flexible, collaborative, and proactive, with the ability to positively impact strategic and tactical initiatives
Excellent communication, judgment, creative problem-solving, negotiation, and conflict resolution skills
Ability to operate as an effective tactical and strategic thinker
Ability to work in a fast-paced environment, manage multiple priorities, and maintain a high level of accuracy and productivity
Strong written, verbal, interpersonal, and presentation skills
Strong proficiency with general Office software such as Word, Excel, PowerPoint, Outlook, SharePoint, Teams

Nice To Haves

Minimum of 5 years of experience in Pharmacy Benefit Management as an Account Executive, Account Manager, or Clinical support, including auditing PBM contracts and pharmacy benefits
Business, Science, Communication, or Math degree

Responsibilities

Support pharmacy benefit consulting activities, including: Preparing, conducting, and analyzing PBM RFPs, including specialty carve-out vendors as requested
Performing audits of pharmacy benefit management contracts and pharmacy benefits using PBM claims data
Participating in and supporting clients’ financial recovery efforts
Reviewing PBM pricing, rebates, performance guarantees, plan design, claim eligibility, and other features impacting plan and participant costs
Advising clients and colleagues on pharmacy matters, emerging market developments, formulary structure, and new drugs to market
Support PBM contract strategy and client issue resolution, including: Clearly defining ambiguous contract terms to help achieve more competitive market terms and rates
Negotiating favorable and transparent contract terms with PBMs
Reviewing contract terms for compliance with plan requirements and client expectations
Communicating complex pharmacy benefit issues clearly and resolving client questions in collaboration with the Health & Welfare consulting team
Building productive relationships with PBMs, vendors, clients, and internal colleagues
Providing guidance and mentorship to colleagues
Participating in training and professional development to further pharmacy benefit and PBM expertise
Contributing to Health & Welfare Practice and firm initiatives as needed
Supporting special projects or assignments related to pharmacy benefits and PBM consulting