Client Relationship Specialist

Job Summary

AnewHealth is a leading pharmacy care management company specializing in complex chronic care needs. The Client Relationship Specialist supports external clients with product inquiries and ensures compliance with regulatory requirements.

Responsibilities

• Serve as main contact for external clients regarding Pharmastar's product lines, including Medicare and Commercial prescription drug data.
• Manage formulary compliance, plan setup, provider management, member enrollment/eligibility changes, patient concerns, reporting, audit support, and claims assistance.
• Perform client outreach and set up recurring calls.
• Prepare, submit, and analyze PDE submissions to CMS; research and suggest solutions for submission rejects; assist in the reconciliation of PDE data; summarize and report PDE progress.
• Coordinate the submission of regulatory reporting to relevant management and agencies; track regulatory updates and changes.
• Build and maintain strong relationships with clients and their pharmacies; present company product line services as needed.
• Ensure adherence to HIPAA guidelines in all communications with clients.
• Stay updated on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines.
• Attend department and company meetings and educational programs as requested.
• Assist with answering Help Desk calls when needed.
• Perform administrative duties as required.

Qualifications

• Bachelor’s degree preferred; Associate’s degree or formal training beyond high school required.
• 3+ years of customer service and industry experience, including health plan or insurance experience, and PBM experience preferred.
• CPhT (Certified Pharmacy Technician) certification, a plus.
• Experience in a pharmacy support role, a plus.
• Current on plan and benefit structures and Medicare Part D guidelines.

Skills & Abilities

• Demonstrated proficiency with resolving common issues, questions, and solutions.
• Knowledge of pharmacology and pharmacological terms.
• Excellent communication skills and professionalism when working with clients.
• Ability to solve problems under pressure by making immediate decisions.
• Detail-oriented and able to prioritize workload.
• Strong computer skills including word processing, spreadsheet, and database software.

Physical/Mental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be able to commute to multiple site locations within assigned territory. May be necessary to work extended hours as needed.

Schedule

This is a full-time position with an expectation to work an average of 40 hours per week and be available outside of normal business hours to meet customer expectations on an ad-hoc basis. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Travel

Travel may be required for special organization or department events, department team meetings, trade shows, conferences, and other client engagements.

Benefits

AnewHealth offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability, as well as voluntary benefits, 401(k), Paid Time Off, and paid holidays.