Clinical Program Advisor - Express Scripts - Hybrid (Rebate Optimization)

Program Management Clinical Advisor

Benefit Driven Rebate Optimization

Overview
B enefit Driven Rebate Optimization works cross functionally with a variety of business partners to manage client rebate eligibility for our full service and externally adjudicated clients.

Our Mission is to perform timely and accurate review of drug rebate eligibility based on the interpretation of applicable clinical drug policies and clients' benefit coverage against the corresponding pharmaceutical manufacturer contract requirements.

This role is integral to ensuring proper rebate invoicing set up to drive the best outcomes for all parties involved.
Responsibilities


* Work cross-functionally with Pharma Contracting, Formulary Consulting, Clinical Account Executives and Pharma Invoicing to assure appropriate interpretation of clinical rules and benefit set up impacts on rebated drug products


* Provide clinical support in documentation of appropriate policies and procedures for analysis and appropriate determination of client eligibility for rebate enhancement and exclusion options.


* Provides clinical/professional support for Benefit Driven Rebate Optimization assignments and/or projects.


* Provide consultative clinical support in the interpretation of rebate requirements contained within manufacturer rebate agreements.


* Provide consultative support determining rebate impacts due to considered changes to formulary and benefits on rebate eligible products


* Other duties as deemed essential by business to support rebates optimization process.

Qualifications


* B.S.

Pharmacy or PharmD


* 1-2 years of benefit analysis in PBM industry.

CAE or CPM experience a major plus


* Pharmacist License required


* Excellent PC skills including Microsoft Office with a high degree of proficiency in Access and Excel required.

Familiarity with SQL would be considered a strong plus.


* Excellent problem solving and communication skills required.

Must be able to work under pressure and perform continual follow up in a timely manner in order to meet tight deadlines.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 96,000 - 160,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure.

That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.

Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.

We also offer 401(k) with company match, company paid life insurance, ...