Pharmacy Account Manager

Pharmacy Account Manager Overview of PositionAs part of Change Healthcare’s Pharmacy Benefit Administration (PBA) business unit, the Pharmacy Manager will provide strategic leadership and direction for the delivery of enterprise-level support and service activities for PBA’s Utah Medicaid client. The successful candidate will act as a liaison, on behalf of PBA, between the customer, technical support, product development, sales, and field service. A strong customer orientation, along with the ability to identify service model improvements, cost reductions, and value-add service opportunities are critical to being successful in the role.Location: Utah / Remote Telecommuter role-prefer someone in the Central/Mountain/Pacific time zones What will be my duties and responsibilities in this job?Responsible for managing and maintaining the relationship with the client of the account(s) they are managing.

Manages single PBM which may include Clinical Services

Clinical services may include clinical and administrative services related to PDL, SR, SMAC, RetroDUR, P&T Committee support, file transfers and maintenance, preparation of weekly drug file and post-P&T Committee meeting updates, maintenance for preferred drug list including budgetary and clinical reports

PBM services include all clinical and administrative services related to online and real time claims adjudication, ProDUR/Concurrent DUR, SMAC, Rebate, file transfers and maintenance, review and maintenance for preferred drug list including budgetary and clinical reports, logistical support for State meetings

Prepares, facilitates, and develops minutes of status meetings (frequency as required by contract and/or customer needs)

Assists with fiscal operations where applicable (provider enrollment paperwork, answering questions from pharmacies trying to enroll, help processing checks, and TPL processing)

Reviews PA’s as necessary (staff on PTO/increase PA load)

Oversees Managed Care Organization (MCO) where applicable, including, but not limited to file transfer, claim adjudication, PDL files, etc.

Enforces business rules and policies

Works with PBA medical/clinical/data staff to analyze and forecast drug trends, summarizing data, and preparing reports

Develops a working knowledge of federal and state specific Medicaid Pharmacy Policy and regulations, PDL/POS rules and suggesting enhancements and/or changes

Provides clinical information and subject matter support

Attends meetings, legislative hearings, and makes presentations upon request of Medicaid Program

Participates in Disaster Recovery plan preparation, updates, tests, and real Disaster Recovery operations

Participates in system enhancements, change requests, defect corrections and other Development/SRE needs as subject matter expert, provide UAT, facilitate customer sign off

Oversees operations of any contractual duties including SLAs and deliverables

Responsible for monitoring and adhering to contract SLAs for each account they are managing

Provides audit support

Responsible for report QA and submission – Weekly, Monthly, Quarterly, Annual and ad hoc reports that need to be QA/QC’d prior to delivery and then delivered to State

Checks Monthly State Bankruptcy reviews where applicable (review for labelers and pharmacy providers)

SSDC meeting (where applicable)– prepares for meeting, attends meeting, and then meets with State frequently to finalize decisions and move forward with first of the year changes

Acts as CHC liaison for all aspects of Change Healthcare – facilities management, approval on all supply orders, invoicing, general account questions, calling command center when issues arise, etc.

Provides On-Call After Hours support;

Supports the Business Development Team as a subject matter expert when needed to develop/review content for proposals as well as support product demonstrations

Travels as required

Additional responsibilities as assigned

What are the requirements needed for this position?5-7+ years in a retail pharmacy or a pharmacy benefit management setting

Minimum B.S in Pharmacy required; Pharm.D. preferred

Must hold a clean and active pharmacy license. Utah pharmacy license preferred

Strong experience with pharmacy claims processing and experience in analytical metrics relating to pharmacy claims

Experience presenting metrics via face-to-face or Web-Ex meetings

Must be qualified to work for federal programs

Experience managing multi-disciplinary teams of resources including administrative functions required

Proficient in Microsoft Office skills to include: Word, Excel, PowerPoint, Outlook

What other skills/experience would be helpful to have?2+ years of account management experience in the healthcare industry, specifically in Pharmacy Benefit Management or large healthcare organization preferred

PharmD or equivalent experience in the industry preferred

PBM experience is preferred

Retail experience is preferred

Managed care experience related to the pharmacy is preferred

What are the working conditions and physical requirements of this job? General office demandsHow much should I expect to travel?Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement. Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! COVID Vaccination Requirements We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCPEEOSupplementFinalJRFQA508c.pdf.If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here https://www.dol.gov/ofccp/pdf/pay-transp%20EnglishformattedESQA508c.pdf to view our pay transparency nondiscrimination policy.California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) . Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.