Clinical Consultant

NFP•Chesterfield, MO

21h•Hybrid

About The Position

The Clinical Consultant position serves as a valued member of Valued Pharmacy Services (VPS). This role directly supports the pharmacy benefit consulting team through all phases of the business. The Clinical Consultant role is responsible for providing clinical assessments of assigned clients plan performance, identifying plan utilization trends or concerns, and providing comprehensive clinical recommendations for the plan to help reduce plan cost while optimizing member health outcomes. Coordinates VPS services to assigned clients, while representing the clients’ interests with the providers, and serving as the clients’ liaison to providers and other internal and external partners. The Clinical Consultant also plays a major advisory role, by providing client consultation regarding clinical opportunities, emerging trends, and best practices. This position also assists in the education of the internal staff to advance VPS’ efforts to increase value by providing innovative cost-effective solutions that help maximize the client’s effort to provide an affordable pharmacy benefit while minimizing disruption to the member and improving health outcomes.

Requirements

Licensed pharmacist in any state.
Preferably a PharmD.
Prefer 2+ years’ experience in clinical consulting.
Preferably with a PBM or Health System.
Understanding of the Employee Benefits industry, and PBM specifically
Knowledge in pharmaceutical clinical review practices
Excellent research skills
Ability to read, analyze 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
Ability to create effective clinical programs for clients
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 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

Responsibilities

Develop and maintain effective working relationships in a clinical liaison role between clients and internal and external partners, such PBMs, brokers, and other account staff.
Communicate with external clients and brokers with clinical insights and clinical program recommendations
Responsible for understanding each assigned client’s business model and organizational structure and keeping in the loop on client news and changes.
Review of claims processing, benefit designs, and financial reports, etc., to ensure they represent the client’s interest.
Represent company as a clinical pharmacy benefit subject matter expert at conferences which may include public speaking events
Engage with clients and brokers to assist in the resolution of all clinically related service problems.
Serve as liaison to VPS’ PBM partners to resolve problematic clinical issues
Make regular service/relationship calls to clients; establish and promote goodwill with customer.
Review client history and follow up with client on a regular basis.
Host clients in the VPS and/or carrier facilities, as needed.
Prepare reports deemed necessary by the leadership and/or broker.
Keep all information on accounts accurate and up to date in the Zoho CRM software or any other client management software that is introduced in the future.
Meet or exceed departmental goals established by leadership.
Keep industry skills and knowledge current by participating in seminars and classes for continuing education.
Assist with the development of 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.
Conduct special projects at the request of the leadership.
Perform related and/or other duties as assigned.