Director, Trade Client Relations

🔥 9 minutes ago

🏄 California, Florida, +2 more states – Remote

🏄 California – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🗽 New York – 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 Client Relations team on Trade related inquiries, initiatives, and opportunity pull through with Participants • Understands downstream impact of rebate and formulary strategy and can convey appropriate messaging to health plan participants for adoption of said strategies and policies • Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation • Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and understanding how to align terms and conditions and translate into UM policy and criteria • Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract compliance • Collaborate and support Client Relations team for Trade related inquiries from Participants • Partner with the following stakeholders: Analytics Team – Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies • Client Relations – Serve as Trade’s primary point of contact for all Participant questions on Trade initiatives and manufacturer contracts and escalate issues as needed to Trade’s leadership • Clinical Team – Liaise with Clinical team to review clinical data and policy requirements as needed • Invoicing Team – Maintain current library of Participant medical and pharmacy policies and support Invoicing team with manufacturer inquiries regarding clinical policies • Product Team – Provide medical policy support for manufacturer related contracts including, but not limited to, cell and gene therapies and other outcomes programs

🎯 Requirements

• Pharmacy degree and Pharm D. 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 levels within an organization • Practical application of clinical data to drive financial value • Strong business and financial acumen, with advanced proficiency in Excel and PowerPoint • Pharmacy residency training or equivalent experience • Experience within the PBM industry, Medicaid, Medicare, and health plans • Experience with contract language and risk mitigation concepts

🏖️ Benefits

• paid time off • 11 holidays • medical/dental/vision insurance • generous 401(k) matching • lifestyle spending account