[Hiring] Director, Trade Client Relations @Blue Cross Blue Shield Association

Role Description

The Trade Client Strategy Director liaises with Synergie Participants and manages clinical policies to comply with manufacturer contracts, implements Trade strategies and initiatives, and collaborates with and supports Synergie’s Client Relations team for Trade related inquiries. This includes medical and pharmacy drug policies, cross benefit management, and rebate qualification for manufacturer contracts. This position will establish and maintain cross functional partnerships with internal teams to drive the identification, development and successful execution of Synergie’s rebate programs. This position will be the primary Trade point of contact for Synergie’s Participant facing activities and will support clinical decision making at the Participant level to comply with manufacturer contracts.

Primary Job Functions

• Consult with Client Relations team on Trade related inquiries, initiatives, and opportunity pull through with Participants
• Understand downstream impact of rebate and formulary strategy and convey appropriate messaging to health plan participants for adoption of said strategies and policies
• Have working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation
• Read and interpret pharmaceutical manufacturer drug contracts and align terms and conditions 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

Qualifications

• 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

Requirements

• Pharmacy residency training or equivalent experience
• Experience within the PBM industry, Medicaid, Medicare, and health plans
• Experience with contract language and risk mitigation concepts
• Travel Requirements: Up to 10% of the time.
• Work is generally performed in a remote setting.

Benefits

• Annual bonus incentive pay
• Comprehensive package of benefits including paid time off
• 11 holidays
• Medical/dental/vision insurance
• Generous 401(k) matching
• Lifestyle spending account
• Many other benefits to eligible employees