Pharmacy Business Management Consultant

PillarRx Consulting

, Remote

Job Category: Client Support

Division: Retail

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Job Summary

Pillar Rx Consulting is seeking a Pharmacy Business Management Consultant to join their team! The Consultant ensures client satisfaction by acting as the subject matter expert regarding Medicare Part D, Medicaid and Exchange type programs. Responsibilities include acting as the liaison and resource for all client related matters concerning these specific areas. This role requires expertise within the Medicare Part D, Medicaid and Exchange programs and an understanding of current and forecasted changes to the industries governing these areas.

Combining nearly 50 years of pharmacy benefit management experience, PillarRx is a leading firm dedicated to delivering pharmacy benefit consulting, auditing, and copay assistance services. PillarRx assists health plans, municipalities, self-funded entities, business coalitions and Taft Hartley plans.

Our qualified professionals lead all aspects of the pharmacy benefit program, helping our customers save money, minimize compliance risks, and refine their PBM contract. We provide best-in-class, value-based pharmacy solutions utilizing 100% review of your pharmacy claims. Our practical compliance guidance can help you maximize your financial outcomes, eliminate pharmaceutical waste & abuse, and increase member satisfaction.

Essential Duties and Functions:

  • Support Clients and PillarRx team members with CMS programs that affect prescription drug benefits
  • Stay up to date with the latest governmental guidance, rules and regulations regarding Medicare Part D, Medicaid and Exchange where it directly affects PillarRx clients
  • Maintains relationship with CMS
  • Support governmental prescription drug program compliance questions and initiatives requested by the PillarRx clients and internal staff
  • Works with internal teams to deliver and service viable products for the industry as it pertains to state and federally regulated lines of business
  • Lead Pharmacy Business Management Services initiative/services implementations on behalf of clients that choose to utilize a new related service from PillarRx
  • Actively participate in the sales and marketing of our services to prospective clients
  • Promote teamwork and actively mentor team members
  • This position will include job duties that require risk designations for access to Electronic Protected Health Information (PHI) in the course of their job responsibilities
  • Other duties may be assigned

Required Skills

Required:

  • Minimum of seven years’ work experience in healthcare or health insurance fields, with a focus on pharmacy related or PBM activities within the state and federal programs space
  • Ability to obtain Medicare systems access (e.g., HPMS access)
  • Minimum 3 years of project management experience
  • Familiar with pharmacy benefit services contracts and their provisions
  • Ability to maintain a high level of confidentiality
  • Proficient with MS Office Suite
  • Available to travel, as needed

Preferred:

  • Bachelor’s Degree preferred in business or related field; Associate degree and/or five years Client Service experience in the pharmacy benefits field

Contact

Raegan Osborn, [email protected] #LI-RO1

We are an Equal Opportunity Employer. We take pride in the diversity of our team and seek diversity in our applicants.