Job Description The Specialty Manufacturer Services - Senior Consultant is The Account Manager (AM) is responsible for developing and maintaining positive relationships with key pharmaceutical manufacturers. This individual is responsible for the day-to-day relationship and support activities and serves as a single point of contact for manufacturer partners.
Become an expert in assigned accounts; manage routine to complex client requests and programs. Requests may include hub and/or third party data aggregator communication and partnership, coordination of copay/financial assistance program rollout, coordination of training, support of manufacturer audits or operational inquiries, and other ad hoc requests.
Be responsible for negotiation and execution of single case payor agreements, Wholesale agreements and account administration and coordination. This position is responsible to ensure reimbursement for non-contracted patients and entities is secure and agreed upon within legal guidelines. This position also acts as liaison between the wholesale pharmacy and AR Coordinators related to account administration issues.
Be responsible for coordination and setup of wholesale accounts, updating accounts when necessary, managing wholesale phone line, facilitate CVS Whole agreement template annual reviews with Legal, work closely with internal partners to ensure smooth operations and successful reimbursement, Assist Pharmacovigilance and Product Safety with annual manufacturer audits and maintain Wholesale database.
Work with internal partners to identify and analyze significant operational or data trends. Work with colleagues toward resolution and support root cause analysis identifying practical and creative solutions, implementing changes, and monitoring for improved outcomes. This includes navigation within the enterprise to engage necessary business/operational units and escalation of issues as appropriate.
Provide effective and timely communication externally, assist with solutioning for manufacturer concerns/challenges, and follow up to ensure pharmaceutical manufacturer expectations are met.
Coordinate and facilitate pharmaceutical manufacturer meetings (business reviews, capabilities, strategy sessions, operations reviews/tours). This includes requesting and/or pulling available data metrics, reviewing performance trends, building a high-quality presentation deck, leading prep meetings with internal stakeholders, and presenting at meetings either in person or via webex/phone.
Support new drug launches and associated time-sensitive activities. Review service and other applicable components of manufacturer contracts, coordinate contract deliverables amongst internal business owners, and ensure accountability and delivery of contractual requirements.
Foster team work and work closely with internal departments (including Specialty Trade, Specialty Pharmacy Operations, Pharma Reporting, Prescriber Sales, Coram, ACS, Legal, Compliance, PBM Account Manager, Finance and others) to ensure best practices and process improvements throughout the enterprise.
Develop and manage projects and initiatives for optimal delivery. This includes development of project plans, establishing timelines and expectations, organizing and setting meeting agendas, documenting notes and action items, conducting follow up, and effectively prioritizing tasks. Additionally, conduct regular project reviews and clearly communicate status of all assigned projects in both formal and informal settings.
Required Qualifications -3 years of healthcare experience
Preferred Qualifications - 3+ years of Health Care Insurance Payer Interface Experience/ Benefit Verification and Accounts Receivable experience -1+ years client facing experience -PBM experience * Excellent organizational and prioritization skills * Excellent verbal, written and communication skills * Excellent Analtical Skills * Ability to gather, compile and prepare reports * Ability to Analyze reports * Exhibits good judgment when escalating issues to management * Ability to complete projects and adhere to deadlines. * Ability to travel up to 10% of the time * Understanding of Billing and Collections Process * Experience working with insurance companies * Able to review and understand contracts * Ability to analyze contracts for redlining * Experience with contractual negotiations * Ability to make business decisions based on position level without further guidance * Excellent customer service skills working with internal and external entities * Excellent ability to prioritize and facilitate communications between numerous parties * Excellent problem solving skills * Self motivated * Ability to manage multiple projects with strict deadlines * Recognizing situations/conditions where change is needed and proactively analyze and offer solutions to solve the issue * Intermediate to expert level in Microsoft Excel and Word, with experience using functions such as; PivotTables, VLookup, Filters, etc * Work individually with a limited level of guidance, and as part of a collaborative team working across departments * Strong project management skills including attention to detail, follow-up and working to tight deadlines.
Education Bachelors degree or equivalent experience may be considered.
Business Overview It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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