$155K - $175K/yr
... 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 ...
$155K - $175K/yr
... 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 ...
Contract Remote Pbm information
What is a contract remote PBM?
A Contract Remote PBM refers to a pharmacy benefit manager (PBM) who works on a contractual basis and operates remotely, rather than being employed full-time on-site. PBMs are companies or professionals that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers. Their primary responsibilities include negotiating with drug manufacturers and pharmacies to control drug spending, processing prescription drug claims, and creating formularies to determine which drugs are covered. A contract remote PBM performs these duties from a remote location, often utilizing digital tools to collaborate with clients and stakeholders.
What skills and qualifications are needed to thrive as a contract remote PBM?
To thrive as a Contract Remote PBM, you need a strong understanding of pharmacy benefit management, contract negotiation, and healthcare regulations, often supported by experience in pharmacy or healthcare administration. Familiarity with PBM software platforms, claims adjudication systems, and knowledge of regulatory compliance tools is essential. Excellent analytical skills, attention to detail, and effective remote communication are standout soft skills for this role. These abilities ensure optimal contract outcomes, regulatory adherence, and seamless collaboration with clients and stakeholders in a remote environment.
What are common challenges faced by contract remote PBMs, and how can they be addressed?
One common challenge for Contract Remote PBM (Pharmacy Benefit Manager) professionals is maintaining clear communication with clients and team members, as remote work can sometimes lead to misunderstandings or delays. Additionally, staying updated on ever-changing pharmacy regulations and plan requirements can be demanding. To address these challenges, it's important to utilize reliable communication tools, establish regular check-in meetings, and actively participate in ongoing training. Building strong relationships with stakeholders and being proactive in addressing client concerns also contribute to successful remote contract management.
What is the difference between Contract Remote Pbm vs Contract Remote Pharmacist?
| Aspect | Contract Remote Pbm | Contract Remote Pharmacist |
|---|---|---|
| Credentials | Licensing, certification in pharmacy benefit management | State pharmacy license, certification (e.g., PTCB) |
| Work Environment | Remote, healthcare/insurance industry | Remote, healthcare/pharmacy industry |
| Employer & Industry Usage | Health plans, PBMs, insurance companies | Pharmacy chains, hospitals, insurance companies |
| Common Search & Comparison | Yes | Yes |
Contract Remote Pbm roles focus on managing pharmacy benefits, requiring knowledge of benefit design and healthcare policies, while Contract Remote Pharmacist roles involve direct pharmacy practice, medication review, and dispensing. Both are remote healthcare positions but differ in responsibilities and industry focus.
What are popular job titles related to Contract Remote Pbm jobs in Alabama?
For Contract Remote Pbm jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Contract Remote Pbm jobs in Alabama look for?
The top searched job categories for Contract Remote Pbm jobs in Alabama are:
What cities in Alabama are hiring for Contract Remote Pbm jobs?
Cities in Alabama with the most Contract Remote Pbm job openings:
$155K - $175K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 29 days ago
Job description
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 Synergie'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.
#LI-Remote
$155,000.00 - $175,000.00This 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.