Director, Trade Client Relations

🔥 15 hours ago

🌾 Nebraska, Oregon, +1 more states – Remote

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

💵 $155k - $175k / year

⏰ Full Time

🔴 Lead

👔 Director

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Blue Cross Blue Shield Association

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1960

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies dedicated to providing affordable and comprehensive healthcare insurance plans. It offers a wide range of health plans for individuals, families, and employers, including Medicare options. Blue Cross Blue Shield Association is committed to promoting health equity and supporting mental health initiatives, aiming to make healthcare easy, affordable, and accessible for everyone. The association is active in health care research and advocates for a more equitable health system.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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