Clinical Consultant - Pharmacy (Remote)
Location: Boston, Massachusetts
Job Type: Full time
****This position has the potential to work remotely.****
Who We Are
We’re NFP, a five-time Best Places to Work award winner in Business Insurance for 2017, 2018, 2019, 2020 and 2021. We are also recognized as an Elite 2018 Agency award winner named as a Top Employee Benefits Firm. We are a leading Insurance Broker and Consultant that provides Employee Benefits, Property & Casualty, and Retirement and Individual Private Client solutions to help our clients reach and realize their goals because we believe business is personal. Our personal commitment to our team and our clients have created long-lasting and successful relationships across our growing 300+ nationwide offices and 17 international locations. To learn more, please visit: https://www.nfp.com/
As a valued member of the pharmacy team with Valued Pharmacy Services (VPS) / NFP RxSolutions, the Clinical Pharmacy Consultant’s main responsibility is coordinating VPS / NFP services to assigned clients, while representing the clients’ interests with the Pharmacy Benefit Manager (PBM), and serving as the clients’ liaison to the PBM and other internal and external partners. As a member of the clinical team, assists in developing and administering effective clinical programs to help our clients control their pharmacy spend. Analytics is a key component of this position. Creating useful information out of data is essential in assisting the sales and account management team in managing clients on a daily basis. Consultant also plays a major advisory role, by providing client consultation regarding Pharmacy Benefits Management (PBM) industry fundamentals, clinical opportunities, emerging trends, and best practices.
This position is also responsible for the education of the internal staff in order to increase market share by providing innovative cost-effective benefit designs that help maximize the client’s effort to provide an affordable pharmacy benefit while minimizing disruption to their members.
Principal Duties And Responsibilities / Essential Functions:
- Develop and maintain effective working relationships in a strategic liaison role between clients and internal and external partners, such PBMs, brokers, and other account staff.
- Communicate with external clients and brokers with clinical insights and clinical program recommendations
- Responsible for understanding each assigned client’s business model and organizational structure and keeping in the loop on client news and changes.
- Present and explain quotes and contracts, benefits and rates to clients; research and answer questions presented by the client regarding quotes and contracts.
- Review of contracts, claims processing, and audit benefit designs, financial reports, etc., to ensure their accuracy and high quality.
- Represent company as a clinical pharmacy benefit subject matter expert at conferences which may include public speaking event
- Assist in the communication of employee benefits in client enrollment meetings and webinars with the appropriate clients and PBM companies.
- Liaise between client, brokers, and PBM companies to independently resolve all service problems. Specifically, assist the client in resolving billing, claim, eligibility, COBRA, and customer service problems.
- Serve as liaison to our PBM partners to resolve problematic clinical issues
- Make regular service/relationship calls to clients; establish and promote goodwill with customer.
- Review client history and follow up with client on a regular basis.
- Host clients in the VPS / NFP and/or carrier facilities, as needed.
- Prepare reports deemed necessary by the Vice President and/or broker.
- Keep all information on accounts accurate and up to date in the Zoho CRM software or any other client management software that is introduced in the future.
- Communicate billing procedures to clients; monitor billing and payments, and ensure that proper billing procedures are followed.
- Meet or exceed departmental goals established by the VP.
- Keep industry skills and knowledge current by participating in seminars and classes for continuing education.
- Assist with keeping department materials, contacts, intranet, etc. up to date.
- Assist with the development of job aids, training materials, etc.
- Present a positive image of self and of VPS / NFP, in and out of the office, to fellow employees, clients, providers, and the community.
- Conduct special projects at the request of the Vice President.
- Perform related and/or other duties as assigned.
- Provide accurate and timely responses to questions from external and internal sources
- Make recommendations based on a client’s drug utilization to internal and external stakeholders
- Draft and coordinate various communications for distribution to internal departments and external customers
Minimum Requirements For Education, Experience, And Certifications/Licenses
- Licensed pharmacist in any state - preference given to a Missouri licensed pharmacist. Preferably a PharmD.
- Prefer 3+ years’ experience in clinical consulting and analysis of pharmaceutical products and clinical programs. Preferably with a PBM or Health System.
Abilities & Skills
- Advanced knowledge in pharmaceutical clinical review practices
- Excellent research skills
- Ability to respond efficiently and accurately to common inquiries or complaints from customers or carrier
- Ability to effectively present information to insured clients and their respective carriers
- Ability to create effective clinical programs for clients
- Excellent oral and written communication skills and command of the English language
- Ability to apply basic mathematical concepts such as percentages, adding, subtracting, multiplying and division to required tasks
- High degree of critical thinking, organizational and decision making skills
- Ability to define problems, collect and analyze data, establish facts, and draw valid conclusions
- High degree of initiative
- High degree attention to detail
- Ability to function independently with minimal supervision
- Ability to prioritize multiple projects and meet objectives and deadlines established by supervisor and clients, often with short turnaround times
- Ability to maintain positive and beneficial relationships with department staff, numerous internal departments, external customers, agents and subscribers
- Proficient in MS Excel, Word, Outlook, and PowerPoint
- Professional telephone skills and e-mail etiquette
- Ability to comply with company confidentiality requirements as well as with HIPAA and other applicable government regulations
This position requires travel 10-20% of the time, with occasional overnight trips.
What We Offer
NFP is proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others.
NFP and You... Better. Together.
NFP is an inclusive Equal Employment Opportunity employer.