- Pharmacy benefit plan design and cost savings strategies
- Customized strategies to enable clients to proactively reduce risk and maximize savings
- PBM performance auditing (post-implementation, financial, and operational as appropriate)
- Specialty pharmacy management for retail and medical specialty medications
- Evaluation of on-site pharmacies at client locations
- Contribute pharmacy and related perspectives to broader health and benefits projects including population health and DEI strategies.
- Support the generation of new business by participating in prospecting opportunities with new clients
- Serve as a pharmacy benefit subject matter expert and trusted advisor to clients
- Perform core pharmacist duties including prospective/retrospective drug utilization reviews, comprehensive medication reviews, diabetes programs, and recommendation of changes to a patient's drug regimen as required
- Effectively collaborate with third parties in the administration of a client's clinical pharmacy strategy
- Collaborate with the account team to ensure alignment among client culture, expectations, and goals
- Contribute to the design and evolution of technology-enabled processes to create a scalable clinical pharmacy operation
- Stay abreast of pharmacy regulatory standards and ensure that they are met consistently
- Support and facilitate the pharmacy marketing process, including:
- Creation, editing, and management of content to be included in the pharmacy profile and RFP
- Internal recommendation of vendors to be invited to complete profiles
- Recommendation to clients of Tier I and II pharmacy vendors to invite to the RFP process
- Scoring and presentation of results to clients
- Negotiation of terms and rates for PBM services
- Actively support clients in the implementation of new PBM partners or programs
- Support the development and management of the Medical Specialty program
- Work with PBMs to customize formularies to include custom exclusions based on lowest ingredient cost or lowest net cost as applicable/appropriate; provide annual review and revision of client and custom formularies
- Review PBM formularies and post to applicable client microsites
- Review monthly MRC reports and work with the Actuarial team on pharmacy/clinical talking points to be presented in the client report
- Using MRC reports, review wasteful drugs and work with PBMs to understand formulary placement and strategy
- Conduct PBM market checks as needed
- Create and distribute high-cost claimant monitoring reports for designated clients
- Support Account and Actuarial team in the delivery of standard reporting to include high[1]cost claimant, relevant pharmacy news, and pharmacy utilization trends
- Clinical licensure (LPN, RN, etc. at minimum)
- 7+ years' experience in the design/management of large group pharmacy benefit plans (consulting, brokerage, or carrier/pharmacy benefit manager environment)
- Expert level knowledge of HIPAA requirements
- State Life and Health license, or willingness to obtain within 90 days
- Previous success in managing client issues/relationships
- Project management experience
- PharmD or RPh designation, Preferred
- Excellent written and verbal communication skills
- Task-oriented, conscientious, ambitious, and self-motivated
- Ability to set and manage client expectations
- Ability to strategically plan and set/meet goals
- Flexibility and proven ability to identify and resolve issues
- Adaptability to change in the work environment, managing competing demands and frequent change, delays, or unexpected events
- Ability to work independently with minimal direction
- Critical thinking and analytical problem-solving skills
- Customer-focused attitude
- Organization, accuracy, and attention to detail
- Excellent project management skills with the ability to prioritize multiple complex tasks
- Integrity, judgment, and commitment to maintaining the highest level of confidentiality
- Ability to make sound, timely decisions that propel the company forward
- Ability to develop PowerPoint presentations according to Piper Jordan standards
- Active listening, sensitivity to the audience, and follow-up skills
- Professional and ethical business practices, adherence to company standards, and commitment to personal and professional development
- Excellent growth and advancement opportunities
- Competitive pay based on experience.
- Paid time off
- Generous benefits package: health, dental, vision, 401(k), etc.
- Employee Stock Purchase Plan
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Senior Pharmacy Consultant- Remote - San Diego, CA, United States - Brown & Brown Insurance
Description
Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.
Piper Jordan is seeking a Senior Pharmacy Consultant for its growing team Piper Jordan is a rapidly growing consulting firm offering state-of-the-art employee benefits solutions to national employers. Entrepreneurial spirit has been a major factor in Piper Jordan's success. What You'll Do Provide value-added consulting experience on sophisticated pharmacy benefit projects, including:
