Pharmacy Account Manager
Pharmacy Account Manager
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$ 63 - 68
1 Vacancy
Job Description
Jobtitle: Pharmacy Account Manager
Location: Remote must sit in CST or EST
Job Summary:
The Pharmacy Account Manager plays a pivotal role in providing operational and clinical support for pharmacy benefits across sales account management and plan sponsor functions. This position is responsible for managing endtoend Pharmacy Benefit Manager (PBM) implementations ensuring timely and accurate claim adjudication and serving as the primary liaison between the Health Plan and PBM partners. The role supports enterprisewide pharmacy installations Medicare compliance efforts (including PDE submissions) and acts as a subject matter expert on benefit setup reporting and pharmacyrelated inquiries.
Key Responsibilities:
- Educate internal stakeholders (sales account management) on pharmacy benefit structures policies and value propositions.
- Lead the setup of pharmacy benefits for new accounts including RFP support and implementation with PBM partners.
- Act as a daytoday liaison for pharmacy operations addressing inquiries from plan sponsors members and internal departments.
- Use PBM reporting platforms to generate and deliver adhoc and standard pharmacy reports to support strategic account decisions.
- Oversee enterprisewide pharmacy implementations including installation claim adjudication testing and accumulator validations.
- Troubleshoot claim adjudication and benefit configuration issues in collaboration with PBM partners and internal systems teams.
- Lead PBM implementation meetings and ensure all data exchanges and operational inputs are aligned with system and regulatory requirements.
- Monitor inbound and outbound eligibility and accumulator feeds addressing any fallouts or inconsistencies promptly.
- Maintain operational SLAs and quality benchmarks for pharmacy support teams ensuring a high standard of service delivery.
- Provide expert support on Medicarerelated inquiries including plan copays deductibles and sales questions.
- Lead Medicare Part D operations support including PDE file preparation and submission.
- Collaborate with marketing and compliance teams to ensure readiness and accuracy of materials for the 2026 Medicare plan year.
Key Skills & Competencies:
- Indepth knowledge of PBM operations claim adjudication systems and pharmacy benefit configuration.
- Familiarity with Medicare Part D PDE processes and CMS compliance standards.
- Strong crossfunctional collaboration skills especially with IT compliance sales and PBM vendors.
- Experience in project management and benefit implementation oversight.
- Proficient in pharmacyrelated reporting tools and platforms.
- Effective communicator and team leader capable of translating complex pharmacy benefit language to nonclinical audiences.
- High attention to detail and ability to maintain SLA and quality standards in a dynamic environment.
Qualifications:
- PharmD required.
- Minimum of 5 years of experience in pharmacy benefits management health plan operations or a related field.
- Experience working with PBM vendors and implementing pharmacy benefits.
- Strong analytical skills with experience in datadriven decisionmaking.
- Knowledge of federal and state regulatory requirements related to pharmacy operations.
- Proficiency in Microsoft Office Suite and PBMrelated software platforms.
Pay: The pay for this role is $63$68 an hour DOE.
Benefits through CGC:Dental Vision STD and/or LTD Voluntary Life & AD&D Accident Critical Illness Hospital Indemnity Health Advocate EAP and Health Equity Commuter Benefits ZayZoon and 401k.
We are anequalopportunityemployer and prohibit discrimination/harassment without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws
Required Experience:
Manager
Employment Type
Contract
