Director Trade Client Strategy - Synergie Medication Collective

Blue Cross Blue Shield Association; Michigan; Remote; USD 155,000 - 175,000; Full time

Job summary

A leading health insurance provider is seeking a Trade Client Strategy Director in Michigan. This role involves managing clinical policies and liaising with stakeholders to ensure compliance with manufacturer contracts. Applicants should have a pharmacy degree or Pharm D. and 5-7 years of experience in healthcare or pharmaceutical contracting. Strong communication and analytical skills are essential. The position offers a competitive salary range of $155,000 - $175,000 and is work-from-home flexible.

Benefits

Paid time off

11 holidays

401(k) matching

Medical/dental/vision insurance

Qualifications

• 5-7 years of experience in healthcare, pharmacy benefit management, or related fields.
• Excellent verbal and written communication skills.
• Ability to establish rapport within an organization.

Responsibilities

• Consult with Client Relations on Trade inquiries.
• Manage clinical policies to ensure compliance with manufacturer contracts.
• Collaborate with internal teams on clinical policy decisions.

Skills

Pharmaceutical knowledge

Client relationship management

Data analysis

Communication

Financial acumen

Education

Pharmacy degree

Pharm D.

Tools

Excel

PowerPoint

Job description

The hiring range for this role is:

$155,000.00 - $175,000.00. This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate's position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company\'s sole discretion unless and until paid and may be modified at the Company\'s sole discretion, consistent with the law.

Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs - ones that are injected or infused by a health care professional in a clinical setting - for nearly 100 million Americans. 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 Synergy\'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
• Understands downstream impact of rebate and formulary strategy and can convey appropriate messaging to health plan participants for adoption of said strategies and policies
• Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation
• Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and understanding how to align terms and conditions and translate 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

Education, Experience, and Certification

• 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

Knowledge, Skills, and Abilities

• 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.

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