Pharmacy Clinical Account Manager

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visitemblemhealth.com . If you’rean EmblemHealth employee, unlock your career potential by signing in at the top of this page. Access your employee profile to view internal job postings and explore new opportunities. Manage client relationships and provide clinical and operational expertise related to pharmacy benefits. Work with internal departments (sales, claims, contracting, marketing) to serve accounts effectively and ensure compliance. Partner with Account Manager(s) as account co-owners in many instances. Analyze account and service provision data, developing and presenting quarterly and ad hoc reports to clients. Collaborate with sales and account management on new prospects and current account renewals as relates to the pharmacy benefit. Support sales, marketing, account management and bid support by serving as the main point of contact for clinical client inquiries related to clinical strategies, formulary, drug pipelines, utilization management, clinical edits, clinical and financial trends, PBM and health plan clinical operations functions and issue resolution. Responsibilities Provide support to account management teams, focusing on client satisfaction, trend management, clinical strategies, and client retention. Build and maintain strong relationships with key client decision-makers with a particular focus on clinical and executive staff, understanding their healthcare strategies, and making recommendations that align with those strategies. Analyze pharmacy claims data to identify trends, providing clinical recommendations, and developing customized clinical business plans and reports. Offer expert clinical advice to pharmacy partners, including formulary management, utilization management, and drug trend analysis. Support member issue resolution and contribute to process improvement efforts within the team. Ensure client contractual requirements are met and participate in contract renewals. Interpret and analyze pharmacy claims data to identify trends to present and provide actionable insights. Proactively identify opportunities for clinical and operational recommendations and strategies. Collaborate with internal teams (sales, business development, technical) to provide clinical expertise and support. Qualifications Bachelor of Pharmacy or PharmD Registered Pharmacist: Licensed Pharmacist by a US State Board of Pharmacy 5 – 8+ years of relevant professional work experience (Required) 3 – 5+ years of experience in product management or related field, including pharmacy benefits management, healthcare, or managed care. (Required) Proficiency in analyzing large datasets and interpreting pharmacy claims data (Required) Strong analytical and problem-solving skills, with the ability to identify trends and develop data-driven solutions (Required) Excellent communication and interpersonal skills with the ability to effectively communicate with diverse audiences, including technical and non-technical stakeholders (Required) Excellent presentation skills with the ability to develop and present reports with complex clinical information in an easy-to-understand way to non-clinical client audiences (Required) Ability to work in a fast-paced, matrixed environment, able to successfully work across a collaborative, cross-functional team environment (Required) Strong proficiency in project management methodologies (Required) Additional Information Requisition ID: 1000003146 Hiring Range: $92,880-$178,200 Security Disclosure If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail. Pay Disclosure At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation. EEOC Statement We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law. Sponsorship Statement At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs. #J-18808-Ljbffr EmblemHealth