Overall oversight and management of client contract compliance, performance guarantee measurement and reporting.
Develops strong internal relationships and contacts within the company that are supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
Ensures Service Level Agreement performance.
Supports the account management team to ensure performance standards are measurable and realistic to achieve and/or exceed to avoid penalties.
Partners with Operations and Network on performance monitoring. Manages methodology, reporting and communications.
Ensures all customer and account-facing services are provided in a consistent and timely fashion.
Maintains reporting calendar to ensure timely submission.
Analyzes data and reporting and supports executive summary development.
Resolves or appropriately escalates customer service issues in conjunction with operations (claims, service, and systems).
Builds relationships and alliances with matrix partners.
Understands the customer's structure and demonstrates the ability to apply this knowledge in business and retention planning for the client.
Coordinates with Compliance and Legal departments on knowing and understanding regulations and the implication to customer impact and ensuring contract compliance
Maintains a client audit schedule to ensure a proactive approach in supporting critical client compliance.
Coordinates all customer audit preparation and execution.
Supports in the development and maintenance of a strategic business plan that fully reflects the customer's business objectives and how the company's solutions align to those objectives and specifically guides our operational, financial, network, clinical and relationship initiatives.
Proactively communicates to internal and external contacts.
Demonstrates contract understanding and detailed knowledge of business requirements.
Supports the account management team in the definition of customer reports and ensures coordination with the client.
Prepares and supports presentations of customer reports with meaningful analytics, trending and recommendations for program improvement based on findings.
Develops strong relationships which penetrate the customer at various levels involving other internal company staff to maintain multiple connections and strengthen the overall relationship.
Contributes to overall account satisfaction within the company as well as satisfaction with all specific areas particularly account management.
Demonstrates knowledge of the company's products and services, and how multiple products and services are interdependent within the customer contract deliverables and clinical outcomes. Maintains in-depth knowledge of client.
Other Job Requirements
Requires Bachelor's degree plus five years of Pharmacy Benefit Management (PBM) experience.
May consider an additional four years of related experience in lieu of degree.
Prefer experience in account management, business analysis or call center operations.
General Job Information
PBM (Pharmacy Benefit Management)
A Combination of Education and Work Experience May Be Considered. (Required), Bachelors (Required)
License and Certifications
License and Certifications
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
Magellan Health Services