Director, Trade Client Relations

🕒 2 dias atrás

🌾 Nebraska, Oregon, +1 estados a mais – Remoto

🌾 Nebraska – Remote 🌲 Oregon – Remote ⚔️ Virginia – Remote

💵 $155.000 - $175.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Blue Cross Blue Shield Association

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1960

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Blue Cross Blue Shield Association é uma associação de empresas independentes, operadas localmente, dedicadas a oferecer planos de seguro de saúde acessíveis e abrangentes. Oferece uma ampla gama de planos de saúde para indivíduos, famílias e empregadores, incluindo opções do Medicare. A Blue Cross Blue Shield Association está comprometida em promover a equidade em saúde e apoiar iniciativas de saúde mental, com o objetivo de tornar o atendimento à saúde fácil, acessível e disponível para todos. A associação é ativa em pesquisa de cuidados de saúde e advoga por um sistema de saúde mais equitativo.

Descrição

• Consult with the Client Relations team on Trade-related inquiries, initiatives, and opportunity pull-through with Participants • Convey messaging to health plan participants regarding rebate and formulary strategies and policies • Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract compliance • Collaborate with the Client Relations team on Trade-related inquiries from Participants • Serve as Trade’s primary point of contact for Participant questions on Trade initiatives and manufacturer contracts • Escalate issues to Trade leadership as needed • Collaborate with Analytics on drug trends, utilization data, clinical policy decisions, formulary compliance, drug share shift, and utilization management strategies • Liaise with the Clinical team to review clinical data and policy requirements • Maintain the library of Participant medical and pharmacy policies • Support the Invoicing team with manufacturer inquiries regarding clinical policies • Provide medical policy support for manufacturer-related contracts, including cell and gene therapies and outcomes programs • Establish and maintain cross-functional partnerships to develop and execute rebate programs • Support clinical decision-making at the Participant level to comply with manufacturer contracts

🎯 Requisitos

• Pharmacy degree and PharmD preferred • 5–7 years of related work experience in healthcare, pharmacy benefit management (PBM), utilization management, pharmaceutical contracting, client relations, or analytical contracting • Must be eligible to work in the United States without need for work visa or residency sponsorship • Excellent verbal and written presentation skills • Ability to establish rapport and build relationships at all organizational levels • Practical application of clinical data to drive financial value • Strong business and financial acumen • Advanced proficiency in Excel and PowerPoint • Knowledge of PBM operations and drug and utilization management strategy and policy implementation • Experience reading and interpreting pharmaceutical manufacturer drug contracts • Experience aligning contract terms and conditions and translating them into utilization management policy and criteria • Pharmacy residency training or equivalent experience • Experience within the PBM industry, Medicaid, Medicare, and health plans • Experience with contract language and risk mitigation concepts • Up to 10% travel

🏖️ Benefícios

• Annual bonus incentive pay • Paid time off • 11 holidays • Medical insurance • Dental insurance • Vision insurance • Generous 401(k) matching • Lifestyle spending account • Work-life flexibility • Well-being benefits • Travel requirements up to 10% of the time