Pharmacy Design Consultant

Pharmacy Design Consultant, Benefit Design

The Pharmacy Design Consultant is the ultimate pharmacy benefit expert. They play a key role in supporting both new client implementations and benefit changes for existing clients. They will use their expertise to ensure the clients benefit intent is consistently and accurately upheld with every new client implementation and benefit change. This role is a blend of behind the scenes work as well as client facing responsibilities. The Pharmacy Design Consultant will attend calls to assist with benefit design set ups, addressing client questions and determining final design requirements. This individual owns the consultative conversations with the client and Employee Benefit Consultant (EBC). They provide a thorough description of benefit set up and product options, as well as strategic recommendations. They also understand the benefit design needs of our clients and program/product requirements from our partnering PBMs.

Job Responsibilities Include:

• Participate in multiple client projects simultaneously while ensuring all role deliverables are accomplished on time and accurately documented
• Complete a second level review of the data gathering process for new client implementations which includes: meticulous review of incumbent plan documents, claim file analysis, and review of other critical benefit design set-up information
• Serves as the pharmacy benefit expert on the following projects: new client implementations, medical vendor changes, eligibility changes, TPA changes, PBM to PBM transitions, and other complex clients requests
• Actively communicates with and relays benefits design set-up information to internal stakeholders including the Project Lead and Benefit Configuration Specialist
• Ensure the client’s benefit intent and benefit design are aligned, accurately documented and communicated
• Attend and participate in client and vendor calls
• Lead consultative and dynamic conversations with clients and EBCs regarding the benefit set-up and program/product selection
• Proactively review existing project workflows/deliverables and communicates process improvement opportunities
• Serves as a benefit expert and resource to support department and corporate initiatives
• Actively seeks to improve product, program, and benefit design knowledge as well as staying up to date on new products and market conditions
• Track and log defined tasks and deliverables within Clarizen
• Appropriately support the risk management team and the Client Command Center process
• Meet KPI goals as defined by Operations leadership and department

Required Skills/Experience Include:

• Bachelor’s degree preferred and 3+ years benefit implementation or pharmacy design experience
• Proven success in a client facing position is desired
• Employee benefits experience required, pharmacy experience a plus
• Experience with project management software desired
• Exceptional partner in collaboration with others
• Proven ability to apply critical thinking practices that results in unique client focused solutions
• Process minded individual who understands the importance of following a consistent process to maximize efficiency & quality
• Solid organizational skills including time management, attention to detail, and ability to manage multiple competing priorities effectively
• Proven experience understanding complex benefit set-ups and providing solid recommendations to assist clients with a transition/renewal
• Sense of urgency necessary to meet goals, objectives, and deadlines
• Excellent interpersonal and human relations skills; able to work collaboratively with people at all levels of the organization
• Excellent written, verbal and presentation skills; able to communicate technical concepts to non-technical personnel
• A passion for learning and a willingness for taking on new challenges
• Ability to make both routine and difficult decisions in a fast-paced, high stress environment