Account Executive, PBA Services

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September 30

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Capital Rx

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Healthcare Insurance • Fintech • Artificial Intelligence

Capital Rx is the fastest growing healthtech company in America, dedicated to transforming the prescription pricing and patient care landscape. Founded in 2017, it offers innovative pharmacy benefit management (PBM) services, including customizable pharmacy benefits for large employers and an AI-powered care navigation platform. Capital Rx focuses on delivering cost-effective solutions and operational efficiencies to clients while ensuring transparency and quality care for patients.

501 - 1000 employees

Founded 2017

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

📋 Description

• Manage the planning, execution, growth & retention and client satisfaction of assigned clients in the Pharmacy Benefit Administration (PBA) market segment including Health Plans, Third Party Administrators (TPAs), and other Platform services • Lead and collaborate through the broader Account Management team and with internal Capital Rx teams/departments as the client voice and advocate • Act as the quarterback and leader of the broader Account Management team; reports to the Senior Account Executive/Senior Director, PBA Client Services • Work closely with Texas-based clients and manage the complexities of working within a highly-regulated market of the TDI (Texas Department of Insurance) • Provide oversight and direction to the broader Account Management team focusing on member and client satisfaction, trend management, client growth & retention, and regulatory compliance • Lead and develop client relationship strategy and strategic business planning across client portfolio • Maintain knowledge and tracking of contractual obligations, including financials, performance guarantees, terms, and reporting/compliance • Manage and facilitate the Account renewal and contracting process with focus on client retention and client financial/PNL management • Serve as the relationship lead on assigned book of business and build relationships with influencers and decision makers • Anticipate customer needs and proactively identify new opportunities within assigned accounts • Develop and maintain comprehensive knowledge of products and services to field client questions timely and accurately • Collaborate with internal teams to customize offerings and assemble internal resources to overcome challenges • Analyze and interpret pharmacy and healthcare trends, competitor activities, and industry regulations to inform strategic decisions • Lead, coach and support the Account Team on positioning Capital Rx value proposition and JUDI capabilities • Partner with Business Development, Underwriting Teams & Senior Account Executives to support PBA account growth, RFP support, and Broker/Consultant engagement • Provide ongoing direction, coordination and coaching to align Account Team understanding of client business lines, strategies, stakeholders & priorities • Serve as the content expert for Health Plan/TPA clients & opportunities • Identify and contribute to process improvement efforts • Own the client end-to-end, inclusive of service model deliverables, contractual negotiations, client escalations and PNL management • Adhere to the Capital Rx Code of Conduct including reporting of noncompliance

🎯 Requirements

• Bachelor’s or advanced degree in health administration, business, or relevant professional experience. Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution is a plus • Relevant professional experience for at least five (5) years in pharmacy – working within a health plan, managed care, or pharmacy benefits management (PBM) focused on Health Plans and Payer Commercial (Insured, Self-Funded, Exchange) and Government Program (Medicare & Medicaid) business lines. Health plan industry experience highly preferred • Market and operational knowledge of Medicare Part D, Medicaid and Health Exchange pharmacy is required along with experience in supporting highly regulated business lines • Track record of building trust in internal and external relationships • Solution-focused problem solving and client positioning skills • Exceptional written and verbal communication skills • Ability to work with and influence peers in a team effort; leading cross-functional initiatives, meeting deadlines, and executing on deliverables while building strong internal relationships • A decisive individual with sound technical skills, analytical ability, good judgement, and strong operational focus and detail-oriented perspective • Flexible, highly organized, and able to shift priorities easily and work independently to meet deadlines • Ability to effectively work with peers in a team effort • Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and large data sets and other industry software programs • Ability to travel and present to small and large groups; travel is estimated to be up to 25% and be variable by season and business cycle • Preferred: Experience working with clients who are subject to TDI (Texas Department of Insurance) rules and regulations