Consultant, Pharmacy Benefits

Nfp • Town and Country, MO

221d • $60,000 - $81,000

About The Position

The Pharmacy Benefits Consultant serves as a critical member of the consulting team. The Consultant is a client facing strategic partner for managing the pharmacy benefits of an assigned book of business. They are the main point of contact for clients, brokers, third party vendors, and internal cross-functional teams related to their book of business. The Consultant also plays an advisory role, by providing consultation regarding Pharmacy Benefit Management (PBM) industry fundamentals, program opportunities, emerging trends, and best practices. This position is also responsible for educating and mentoring internal staff to advance VPS ability to increase market share, provide innovative cost-effective benefit designs, and maximize efforts to provide an affordable pharmacy benefit while minimizing member disruption. The Consultant regularly collaborates with internal teams and external partners regarding contracts & legal compliance, reporting & analytics, clinical recommendations & guidance, marketing, and other miscellaneous projects.

Requirements

• Prefer Bachelor’s degree. Associate’s degree or equivalent from two-year college, minimum requirement.
• Minimum three years of PBM related industry experience.
• Knowledge of the Employee Benefits industry, and PBM specifically.
• 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.
• 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.

Responsibilities

• 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.
• Proficient in the PBM marketplace, including carrier contacts, services, and underwriting requirements.
• 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 semi-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 on a regular basis.
• 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.

Benefits

• Competitive salary
• PTO & paid holidays
• 401(k) with match
• Exclusive discount programs
• Health & wellness programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Food Services and Drinking Places
• Education Level: Bachelor's degree