Sr. Pharmacy Benefit Consultant, Health Plans

Job Description:

The Pharmacy Benefit Consultant - Health Plans will serve as primary and lead consultant on strategic clients’ projects with a focus on national and regional health plans. Lead and cultivate multi-level client relationships with senior executives, pharmacy department leadership and personnel, sales and product leads, clinical management and others which enable PSG to partner with clients to create, communicate and implement pharmacy strategy within the context of the overall healthcare strategy. Identify business needs and create custom solutions for sophisticated clients which include overall pharmacy benefit and medical management initiatives to address the overall goal of healthcare affordability.  Lead vendor (PBM) strategies that will include procurement efforts, contract negotiation and ongoing vendor management. Provide industry expertise and insight related to cost and trend management opportunities.

Responsibilities include:

Client Management

• Identify and maintain appropriate multi-level client relationships and a deep understanding of client business and corporate culture resulting in high client satisfaction and retention rates.
• Develop and implement customized strategic plans based on unique client needs to achieve targeted long- and short-term goals.
• Track and measure vendor contract performance including operational and financial measures.
• Lead and participate in ongoing client meetings including vendor review meetings and independent strategy and performance assessment meetings
• Identify opportunities to engage internal PSG experts on custom projects and analyses.
• Review pharmacy program indicators for ongoing opportunities and program performance measures.
• Maintain ongoing reports and documentation related to client relationships and program performance.
• Responsible for renewal of client relationship and creating strategy, scope of services and appropriate fee structure to match client needs.

Program and Business Development

• Assess opportunity for expanding PSG services within existing client relationship.
• Leverage client relationship for PSG prospecting efforts by creating developing client reference.
• Participation in conferences and other forums for showcasing program experience and success.
• Participate in internal workgroups to develop new programs, services, corporate positions and   publications based on the continual assessment of client and market needs.

Account Implementation

• Provide oversight, guidance and serve as an advocate for the client to ensure vendor requirements are met and service levels are adequate throughout vendor implementation.
• Identify issues and concerns for appropriate escalation and resolution to ensure successful transition.

RFP Process Management

• Lead the development and management of the RFP process for clients including RFP creation, vendor selection meetings and contract execution (in conjunction with internal RFP coordinator).
• Participate in non-client RFP process via scoring and client meeting assistance.

Contract Review and Execution

• Lead the review process for new and renewing vendor contracts through final execution to ensure current terms, definitions and compliance with RFP requirements.
• Lead the creation and renewal of PSG client agreements to create appropriate scope of services and fee structure.

 Qualifications (Minimum Requirements)

• Extensive knowledge of PBM, specialty pharmacy or managed care environments (5-7 years minimum experience).
• Strong verbal and written communication skills including presentation skills and client relationship management experience.
• Ability to develop strategies and implement programs for large client Rx and medical benefit programs
• Strong clinical and financial analysis skills including Word, PowerPoint and Excel
• Pharmacy background with bachelor’s degree; MBA or PharmD/RPh strongly preferred

Business development experience preferred

WHY EPIC:

EPIC has over 60 offices and 3,000 employees nationwide – and we’re growing! It’s a great time to join the team and be a part of this growth. We offer:

• Generous Paid Time off
  • Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days
• Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave
• Generous employee referral bonus program of $1,500 per hired referral
• Employee recognition programs for demonstrating EPIC’s values plus additional employee recognition awards and programs (and trips!)
• Employee Resource Groups: Women’s Coalition, EPIC Veterans Group
• Professional growth & development: Mentorship Program, Tuition Reimbursement Program, Leadership Development
• Unique benefits such as Pet Insurance, Cancer Insurance, Identity Theft & Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause & Midlife Support
• Additional benefits include (but are not limited to): 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness & employee assistance programs
• 50/50 Work Culture: EPIC fosters a 50/50 culture between producers and the rest of the business, supporting collaboration, teamwork, and an inclusive work environment. It takes both production and service to be EPIC!
• EPIC Gives Back – Some of our charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation
• We’re in the top 10 of property/casualty agencies according to “Insurance Journal”

COMPENSATION: 

The national average salary for this role is $160 000.00 - $200,000.00 in base pay and exclusive of any bonuses or benefits. The base pay offered will be determined based on your experience, skills, training, certifications and education, while also considering internal equity and market data.

To learn more about EPIC, visit our Careers Page: https://www.epicbrokers.com/about/epic-careers/. 

EPIC embraces diversity in all its various forms—whether it be diversity of thought, background, race, religion, gender, skills or experience. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard. It is our belief that diversity drives innovation and that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients. 

California Applicants - View your privacy rights at: https://www.epicbrokers.com/wp-content/uploads/2025/01/epic-ca-employee-privacy-notice.pdf. 

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