Company Statement
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, visit emblemhealth.com.
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Pharmacy Account Manager - Remote
- 💼
- EmblemHealth
- 📅
- 5 days ago Post Date
Summary of Job
Manage and nurture client relationships within EmblemHealth’s employer group clients to ensure they have the information, products, and support needed from the health plan. Responsible for building and expanding existing pharmacy service contract accounts. Work with internal departments (sales, claims, contracting, marketing) to serve accounts effectively and ensure compliance. Analyze account and service provision data, developing process improvements as needed. 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 non-clinical client inquiries related to pharmacy benefit setup, claims issues, eligibility, and billing.
Responsibilities
- Identify opportunities for upselling and cross-selling, implementing sales strategies to retain and grow accounts, and tracking sales performance.
- Provide oversight to account management teams and internal partners as relates to pharmacy benefits, focusing on member and client satisfaction, trend management, and client retention.
- Build and maintain strong relationships with key company decision-makers, understanding healthcare strategies, and ensuring client and member satisfaction.
- Work with internal partners to address ongoing service needs, and support Account Management with the Pharmacy Benefit set up and onboarding activities for new clients.
- Develop and deliver quarterly business reviews for key clients.
- Partner with product teams on annual revisions to each product line ensuring lowest cost, highest value plans in the market.
- Direct Pharmacy Benefit Manager (PBM) in plan design activities.
- Respond to and resolve client issue escalations and resolution, working with internal partners to ensure timely responses.
- Track and resolve member issue trends, developing process improvements within the team.
- Ensure client contractual requirements are met and participate in contract renewals.
- Interpret and analyze pharmacy claims data to identify trends and provide actionable insights.
- Monitor assigned client claims and trends to proactively identify area of potential issue. Work with internal teams to develop mitigation strategies for identified issues.
- Perform other related tasks as directed, assigned, or required.
Qualifications
- Bachelor’s degree in business or related field
- 5 - 8+ years of relevant professional work experience in account management, customer service, or healthcare (Required)
- 6+ years of experience in pharmacy benefits management, healthcare, or managed care (Required)
- Prior account management experience (Preferred)
- Proficiency in analyzing large datasets and interpreting pharmacy claims data (Required)
- Strong analytical and problem-solving skills, with the ability to analyze data, 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)
- Ability to work effectively in a fast-paced, collaborative, cross-functional team / matrixed environment (Required)
- Strong proficiency in project management methodologies (Required)
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, 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.