Account Manager - PCMI

About the Role

This position reports to the Director of Account Management for Pinnacle Claims Management (PCMI) and is responsible for managing customer accounts during and after the sale of employer benefit programs and services, including Pinnacle third-party administration (TPA), Pinnacle Rx Solutions (PRxS), Pinnacle Health Management (PHM), and ancillary benefits offered by PCMI vendor partners such as Western Growers Insurance Services (WGIS) employer benefit programs. The Account Manager collaborates with internal operations and administration departments to coordinate pre- and post-sale implementation and ongoing plan support for customer accounts. The role also supports new sales expansion through cross-sale initiatives.

Responsibilities

• Manage the overall servicing of a book of business under the PCMI platform, ensuring day-to-day administration and fulfillment of client and broker needs related to Pinnacle TPA, PRxS, PHM, and ancillary products.
• Advise clients and brokers on self-funding, pharmacy benefits management, care management, utilization review, wellness, stop-loss, and print and distribution services.
• Maintain client reference files on the server for all assigned accounts, documenting past work, work-in-progress, and pertinent information to meet customer and broker needs.
• Monitor projects to ensure adherence to plans and deadlines, proactively identifying potential issues.
• Execute product renewals in a timely manner to maintain a high PCMI retention rate.
• Develop expertise in PCMI system tools, including PERC/WERC/Healthview and HCPS operating systems, to manage customer expectations and deliverables.
• Drive results through process improvement, expectations management, and issue resolution.
• Stay current on laws and regulations impacting the medical insurance industry.
• Analyze reporting related to claims history, pharmacy spend, and chronic disease to identify opportunities for clients to optimize their health plans with PCMI ancillary products.
• Collaborate with the Sales team to strategize and sell additional Pinnacle products, generating additional revenue for PCMI.
• Work with brokers prior to renewal to identify cross-sale opportunities.
• Coordinate with internal departments to generate customer-specific proposals for PCMI offerings.
• Maintain a clear understanding of the competitive landscape to effectively position PCMI products.
• Support the mission of enhancing competitiveness and profitability for members by being collaborative, adaptable, and results-driven.
• Maintain a clean DMV record and travel throughout the U.S. (primarily California and Arizona) up to 30% of the time.
• Maintain an active Life & Health insurance license in California.
• Perform all other assigned duties.

Physical Demands & Work Environment

The employee is regularly required to communicate with others and frequently travels to both indoor and outdoor areas with varying exposure and temperature conditions. The role involves operating a motor vehicle, using tools or controls, and occasionally lifting up to 50 pounds. The work environment is typically moderate in noise level.