Clinical Account Consultant, PBA

Judi Health; Charlotte (NC); On-site; USD 116,400 - 145,500; Full time

Job summary

Judi Health, a health-technology leader, seeks a Clinical Account Consultant to support clinical functions and client needs. You’ll ensure satisfaction, retention, and trend management, while developing formulary and clinical strategies and assisting with contract renewals.

You’ll collaborate with clients to deliver clinical excellence, analyze pharmacy data, and contribute to process improvements across plans and business lines. Occasional travel may be required.

Qualifications

• PharmD degree from an accredited institution.
• Current, unrestricted pharmacist license.
• 3–5 years of health plan or PBM experience.
• Direct account management experience across multiple lines of business.
• Proficient in Microsoft Office; strong Excel data handling.
• Excellent written and verbal communication; able to balance multiple projects.

Responsibilities

• Support clinical aspects of implementation for new clients and plan changes.
• Manage custom formularies, clinical criteria, and strategies for clients.
• Explain formulary and clinical programs to clients with supportive rationale.
• Meet with clients to discuss trends and provide evidence-based recommendations.
• Analyze pharmacy claims data to identify trends and insights for clients.
• Collaborate with cross-functional teams for sales initiatives and RFPs.
• Attend meetings and client presentations focusing on clinical operations.
• Lead internal clinical operations initiatives and process improvements.
• Possibly participate outside standard hours during peak periods.

Skills

Communication skills

Data analysis

Multi-project management

Excel proficiency

Education

Doctor of Pharmacy (PharmD)

Tools

Microsoft Excel

Job description

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health.

Position Summary

Capital Rx is seeking a strategic, client-focused Clinical Account Consultant to support all aspects of clinical functions to service client clinical needs. In this role, you'll ensure client satisfaction, retention, and trend management, while providing clinical support to clients across all lines of business. You’ll collaborate directly with clients to develop and implement formulary and clinical strategies, support contract renewals, and contribute to clinical process improvements. If you’re passionate about delivering exceptional service with a focus on clinical excellence and driving healthcare innovation, we’d love to hear from you!

Position Responsibilities

• Support clinical aspects of implementation for new clients, plans, plan changes, and other clinical plan set-up requirements. This may include gathering client clinical intent and plan requirements, building/coding plans and formularies, conducting peer-review quality control, and reviewing testing and claims output.
• Actively address all clients’ clinical needs including the management and implementation of custom formularies, clinical criteria, and clinical strategies.
• Comprehend and effectively explain formulary, benefit, and clinical programs to clients, including intervention components, member and plan experience, book of business experience, and regulatory requirements as it directly pertains to clinical functions.
• Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for formulary, clinical and plan management strategies.
• Analyze and interpret pharmacy claims data to identify clinical and plan trends and to offer insights for individual clients and across multiple clients.
• Communicate drug information to clients and respond to plan-specific clinical inquiries; support resolution of member-specific inquiries.
• Collaborate with cross-functional teams to support sales initiatives, requests for information (RFI), requests for proposal (RFP), and prospect presentations.
• Actively attend and contribute to sales meetings and client presentations with a focus on clinical operations and clinical account management.
• Lead key internal clinical operations initiatives and general business needs/operations, as required.
• Identify and contribute to clinical process improvement efforts.
• Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications

• Doctor of Pharmacy (PharmD) degree from an accredited institution
• Current, unrestricted registered pharmacist license(s)
• Relevant experience of 3-5 years in a health plan or pharmacy benefits management (PBM)
• Direct account management experience supporting clients across multiple lines of business
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel
• Experience working with large datasets and analyzing raw data in Excel
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high quality work product
• Ability to travel and present to small and large groups

Preferred Qualifications

• Completion of managed care residency, preferred
• Prior account management experience of at least three (3) years, preferred
• Prior experience with Medicare line of business, preferred

New York, NY Salary Range: $139,600 USD - $174,500 USD

Denver, CO Salary Range: $128,000 USD - $160,000 USD

Charlotte, NC Salary Range: $116,400 USD - $145,500 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of noncompliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.