(Hybrid) Clinical Consultant

About the role

The Clinical Pharmacy Benefit Consultant position serves as a valued member of Valued Pharmacy Services (VPS). This role directly supports the pharmacy benefit consulting team through all phases of the business. The Clinical Consultant role is responsible for providing clinical assessments of assigned clients' plan performance, identifying plan utilization trends or concerns, and providing comprehensive clinical recommendations for the plan to help reduce plan cost while optimizing member health outcomes. They coordinate VPS services to assigned clients, representing the clients' interests with providers and serving as their liaison to providers and other internal and external partners. Additionally, they play a major advisory role by providing client consultation regarding clinical opportunities, emerging trends, and best practices.

Responsibilities

• Develop and maintain effective working relationships in a clinical liaison role between clients and internal and external partners, such as PBMs, brokers, and other account staff.
• Communicate with external clients and brokers with clinical insights and clinical program recommendations.
• Understand each assigned client's business model and organizational structure and keep informed on client news and changes.
• Review claims processing, benefit designs, and financial reports to ensure they represent the client's interest.
• Represent company as a clinical pharmacy benefit subject matter expert at conferences, which may include public speaking events.
• Engage with clients and brokers to assist in resolving clinically related service problems.
• Serve as liaison to VPS' PBM partners to resolve problematic clinical issues.
• Make regular service/relationship calls to clients; establish and promote goodwill with customers.
• Host clients in VPS or carrier facilities, as needed.
• Prepare reports deemed necessary by leadership or brokers.
• Keep all information on accounts accurate and up-to-date in the Zoho CRM software or any other client management software introduced in the future.
• Maintain departmental goals established by leadership.
• Stay current on industry skills and knowledge by participating in seminars and classes for continuing education.
• Aid in the development of job aids, training materials, etc.
• Present a positive image of self and of VPS, in and out of the office, to fellow employees, clients, providers, and the community.
• Conduct special projects at the request of leadership.
• Perform related and/or other duties as assigned.

Requirements

• Licensed pharmacist in any state. Preferably a PharmD.
• Prefer 2+ years' experience in clinical consulting. Preferably with a PBM or Health System.

Qualifications & Skills

• Understanding of the Employee Benefits industry, and PBM specifically.
• Knowledge in pharmaceutical clinical review practices.
• Excellent research skills.
• Ability to read, analyze, and interpret industry policies and contract documents, as well as proposals and other documentation and correspondence.
• Ability to respond efficiently and accurately to common inquiries or complaints from customers or carriers.
• Ability to effectively present information to insured clients and their respective carriers.
• Excellent oral and written communication skills and command of the English language.
• Ability to apply basic mathematical concepts such as percentages, adding, subtracting, multiplying and division to required tasks.
• High degree of critical thinking, organizational, and decision-making skills.
• High degree of initiative.
• High degree attention to detail.
• Ability to function independently with minimal supervision.
• Ability to prioritize multiple projects and meet objectives and deadlines established by supervisor and clients, often with short turnaround times.
• Ability to maintain positive and beneficial relationships with department staff, numerous internal departments, external customers, agents, and subscribers.
• Proficient in MS Excel, Word, Outlook, and PowerPoint.
• Professional telephone skills and e-mail etiquette.
• Ability to comply with company confidentiality requirements as well as with HIPAA and other applicable government regulations.

What We Offer

• Competitive salary
• PTO & paid holidays
• 401(k) with match
• Exclusive discount programs
• Health & wellness programs
• Travel up to 10% of the time, with occasional overnight trips

Base Salary Range

The base salary range for this position is $111,000.00 – $150,000.00. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.