Clinical Account Consultant, PBM
Judi Health · New York, NY · 2 mo ago
HybridBusiness Development$140k/yrFull-time
Position Summary
The Clinical Account Consultant (CAC) is a clinical subject matter expert behind a portfolio of pharmacy benefit management clients. Responsibilities include turning complex claims data, clinical guidelines, and market shifts into clear, data-driven recommendations. This role partners closely with Account Executives and internal teams to improve member outcomes and pharmacy benefit performance across the client lifecycle.
Responsibilities
Shape Clinical Strategy
- Analyze pharmacy claims, utilization, and drug trend data to surface insights and build evidence-based recommendations across formulary, utilization management, specialty, and clinical programs.
- Translate treatment guidelines, pipeline developments, and market trends into client strategy and assess its clinical impact.
Drive Clinical Program Execution & Client Delivery
- Operationalize approved recommendations with internal teams so clinical intent is accurately reflected in formulary changes, utilization management initiatives, and other pharmacy benefit enhancements.
- Review disruption analyses, clinical readiness materials, and post-go-live outputs to support accurate execution and a strong client/member experience.
- Build client-ready clinical content for quarterly business reviews, strategic reviews, renewals, finalist presentations, and other client needs – then present findings and field clinical questions directly.
Build to Scale
- Partner with Account Executives, analytics, operations, product, and other internal teams to align clinical strategy with operational execution and platform capabilities.
- Contribute to the development of standardized clinical tools, templates, and best practices that raise quality, efficiency, and consistency across the team.
Additional Responsibilities
- Support general business and team needs, as required.
- Certain times of year may require meeting participation, testing, claims review, or other support outside of standard business hours, including weekends.
Required Qualifications
- Doctor of Pharmacy (PharmD) degree from an accredited institution.
- Active pharmacist license, or ability to obtain/maintain licensure as required.
- 3–5 years of experience in PBM, managed care, or health plan environments.
- Strong clinical knowledge of formulary management, utilization management, clinical programs, and pharmacy trend analysis.
- Experience analyzing pharmacy claims data and translating findings into actionable clinical recommendations.
- Ability to explain complex clinical concepts clearly to both clinical and non-clinical audiences.
- Strong written and verbal communication skills.
- Highly organized and able to manage multiple priorities in a fast-paced, cross-functional environment.
- Proficiency in Microsoft Office Suite, including Excel, and experience working with large data sets.
- Ability to travel and present to small and large groups; travel is estimated not to exceed 25%.
Preferred Qualifications
- Experience supporting formulary strategies, utilization management programs, or specialty pharmacy initiatives.
- Experience contributing to client-facing clinical presentations and strategic recommendations.
- Familiarity with implementation support related to formulary strategy, disruption review, or clinically driven benefit setup.
- Experience working in a highly collaborative, matrixed environment.
Salary Range
- New York, NY: $140,000 USD - $160,000 USD
- Denver, CO: $140,000 USD - $160,000 USD
- Charlotte, NC: $140,000 USD - $160,000 USD