Pharmacy Claims Remote Jobs in Indiana (NOW HIRING)

About Us

As a rapidly growing organization, Innovative Rx Strategies is distinguished by its commitment to advocating for clients both personally and financially while delivering measurable cost savings for employers and their employees.

Are you interested in joining a successfully growing organization that has been recognized for over a decade as a Best Place to Work, recipient of Healthiest Workplace awards, and The Platinum Bell Seal for Workplace Mental Health? If so, come join our Innovative Rx Strategies team of clinical experts!  

Our team serves employers, benefits brokers, TPAs, health care systems and health plans with deep understanding of the pharmacy benefits markets and health care industry trends. With expert knowledge we are committed to one mission — breaking down a complex industry to save our clients' money on their benefits programs and manage their cost trends.

Innovative Rx Strategies is an Apex Benefits Group, Inc. (ABG) company. ABG offers competitive benefits, flexible hybrid/remote work model, a collaborative team environment, and advanced training and development.

Job summary

The Clinical Account Executive leads account management for their book of business while setting the strategy and direction for their account team support. Develops client strategy and ensures the execution to provide overall day-to-day clinical consulting and account management to ensure the effective execution of client objectives and the PBM contract. This role is ideal for a strategic, client-focused professional with deep expertise in pharmacy benefits and healthcare consulting. The position blends account management, data analysis, vendor oversight, and clinical advisory services to deliver high-impact solutions for employer-sponsored health plans. You’ll lead client engagements, interpret complex client and PBM data, monitor pharmacy performance, and guide decision-making around complex pharmacy benefit strategies. With responsibilities spanning compliance, client performance, and team coordination, this role offers a dynamic opportunity to shape pharmacy benefit outcomes across diverse employers.  

The starting salary for this position begins at $160,000. Final compensation will be determined based on experience, qualifications, internal equity, and market considerations.

Summary of essential job functions/responsibilities

 Account Management

• Develop client communication strategy for team delivery
• Ensure exceptional delivery of customer support, including interpreting plan designs, resolving claims and member issues, and addressing benefit and enrollment inquiries
• Ensure client’s overall positive impression of the company by ensuring timely completion of all client deliverables and resolution to all experienced issues. Conduct routine onsite account visits as needed

 Data Management

• Lead data assessments, trend analysis, and reporting for clients and company book of business needs
• Develop strategy around routine trend reports and annual performance reviews and support team through the completion
• Plan and ensure the execution of all client deliverables including annual reconciliation and market check processes
• Collaborate with account support and analytics teams to monitor pharmacy claims performance, identifying opportunities to enhance benefits, close clinical gaps, and drive cost savings

 Vendor Management

• Ensure vendors meet client-specific needs and timelines
• Interface with PBM operations to resolve issues efficiently
• Lead strategy and the account team’s role in implementation of new PBMs, programs, and services
• Ensure completion and accuracy of all contracts for the client with their vendors
• Provide clinical insight during vendor evaluations and the selection of pharmacy benefit managers and consulting solutions

 Clinical & Advisory Services

• Develop comprehensive individual client pharmacy benefit strategies, staying ahead of the current trends based on your knowledge and learning in the field
• Develop client guidance by driving informed decisions considering efficacy and cost related items in a population health focused manner for new-to-market and high-cost drugs on both the pharmacy and medical benefit
• Create client specific strategies for plan design decisions including
• Monitor and interpret compliance and legislative changes, advising clients and ensuring adherence to regulatory requirements

Team Leadership Responsibilities

• Lead internal meetings and processes ensure compliance and team accountability
• Develop and mentor account managers to execute client strategy
• Development of written and presentation-based thought leadership pieces on pharmacy benefits and PBM related topics  

Minimum requirements

• Pharmacy degree required; PharmD or Pharmacy Residency preferred
• A minimum of 10 years of practical pharmacy experience required or equivalent with a managed care pharmacy residency; previous PBM or Pharmacy Benefit experience preferred.
• Knowledge of current business and industry trends
• Superior problem solving, analytical ability, attention to detail and customer service skills
• Positive attitude, willingness to learn and interest in working towards team goals
• Relationship builder
• Excellent organizational and time management skills
• Highly developed reasoning and problem-solving skills
• Strong verbal communication skills, with ability to present in person with clients and prospects
• Self-motivated, with ability to meet deadlines; ability to work productively and proactively
• Ability to plan, organize, and work on multiple tasks simultaneously and exercise independent judgement
• Proficient in Excel, Word, PowerPoint, and other analytic tools that may be introduced
• Abide by all obligations under HIPAA related to Protected Health Information (PHI) and Capable of maintaining confidential information

Additional Information

Apex Benefits Group, Inc believes in equal opportunity employment and does not discriminate based on age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability, or any other legally protected status.

This is a remote position with travel requirements. Must be able to travel for meetings, training, conferences, and/or client visits approximately 6–10 times annually, including occasional overnight stays.

This role is U.S.-based and operates primarily within Eastern Time Zone.  We have a preference in states where we currently employ team members, including Indiana, Ohio, Illinois, Kentucky, Texas, North Carolina, Tennessee, and Pennsylvania.