Account Executive, PBM

Location: Hybrid (Local to NYC or Denver area)

Capital Rx is looking for a results-driven Account Executive - PBM to manage relationships with large and jumbo commercial clients (15,000+ lives) in the health system, employer, labor/union, and public sectors. In this role, you will drive client satisfaction, manage trend strategies, lead renewals, and oversee contract compliance. You’ll collaborate with internal teams to deliver tailored solutions and ensure performance goals are met.

If you’re passionate about building strong client relationships, navigating healthcare trends, and improving processes, we want to hear from you!

Position Responsibilities:

• Provide oversight of commercial clients within the health system, employer, labor/union and public verticals for large/jumbo accounts (>15,000+ lives).

• Serve as the relationship liaison on assigned book of business, incorporating internal support where and when needed to the foster relationship with influencers and decision makers at the plan.

• Develop relationship strategy plans, with support of clinical account manager and operations manager.

• Support member and client satisfaction execution and net promoter score goals.

• Provide deep and approachable trend management recommendations with support of reporting.

• Maintain thorough knowledge of contractual obligations assigned book of business, including financials, performance guarantees, terms, and regulatory/compliance.

• Lead client renewal process, including contract management.

• Lead ownership of performance guarantee reporting and maintenance.

• Lead regulatory and compliance components.

• Interpret current pharmacy and healthcare trends, and meet with clients to provide proactive recommendations for plan management; find ways of adding value to the client curating offerings tailored to the client’s specific needs.

• Identify and contribute to process improvement efforts.

• Assemble internal resources to overcomes challenges.

• Anticipates customer needs and proactively identifies new opportunities within assigned accounts.

• Comprehensive knowledge of our business, including products and services. Able to field questions from the client side, answer them and answer them correctly.

• Review and advise on JUDI product roadmap to ensure current priorities and milestones will meet the client expectation.

• Other duties as assigned.

• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• A knowledgeable and professional individual with appropriate healthcare industry experience with at least 5 years of pharmacy benefits experience required

• Bachelor’s or advanced degree in health administration, business, or relevant professional experience

• PharmD preferred, but not required

• Exceptional business acumen skills

• Strong clinical knowledge and expertise

• Strong data analysis and presentation skills

• Financial and statistical reporting knowledge and experience

• Project management experience preferred

• Ability to exercise considerable judgement, maintain confidentiality, and act in a diplomatic manner

• Travel is estimated to not exceed 25% in the busiest times of year

• Progressive staff management experience

• An educator who is trustworthy and willing to share information and serve as a mentor

• Ability to independently identify, research and resolve issues

• A person who can relate to people at all levels of an organization and possesses excellent communication skills

• An excellent facilitator who is experienced in resolving conflicts between different parties to a dispute

• A decisive individual who possesses a strategic focus as well as an operational, implementation, and detail-oriented perspective

• A strategic planner with sound technical skills, analytical ability, good judgement, and strong operational focus

• Ability to work with peers in a team effort

• Demonstrated ability to manage multiple priorities and deadlines

• A well-organized and self-directed individual who is able to work with minimal amount of supervision

• Capability to efficiently complete tasks in a fast-paced environment

• Ability to work extended hours, weekends, and holidays pursuant with industry demands

• Proficient in Microsoft Office and industry related software programs

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.

 

About Capital Rx 

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.