Post Date: 07/26/2019
Close Date: 08/24/2019
Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
This position would provide strategic external and internal support to large account pharmacy clients and the sale of new pharmacy services business via agents, brokers, consultants, and group administrators. Identifies client requirements, presents offerings and services, determines schedule availability, defines process and related materials, provides quotation & contracts, acquires customer paperwork, mediates processes, resolves issues, communicates job status, obtains customization approvals and performs customer required performance review.
Provides leadership in client pharmacy opportunities and performs major advisory role by providing client consultation on Moda Health’s PBM services and products.
1. Responsible for large accounts, primarily 3000+ employee lives. Works directly with Pharmacy Enterprise & Innovation leadership and Moda Sr. Executive team to manage account development and program design for existing clients. Positions Moda, strategically, for the retention of business and the expansion of new opportunities with clients.
2. Provides ongoing service of major assigned accounts. Includes personal service calls to agents and accounts, responding to both written and oral inquiries from the agent and/or account and the research and problem resolution of service issues with appropriate departments. Regularly interacts with client accounts and coordinates management of pharmacy benefits with Moda’s clinical and operations pharmacy staff. Conducts review of specific account reporting and performance guarantees, monthly, quarterly, and annually, ensuring delivery to agents and/or groups in appropriate timeframe.
3. Provides leadership backup to Director, Pharmacy Services in responding to day-to-day support needs and assisting in the training and development of the service team.
4. Coordinates assignments with sales coordinator personnel in support of Pharmacy Services activity.
4. Reviews and analyzes underwriting renewal proposals, prepares and presents renewal letter to agent and/or account. Coordinates benefit design changes, annual enrollment meetings, design and development of literature, Certificates of Coverage, and coordination of new ID cards and communications.
5. Assists proposal team in the Request For Proposal (RFP) process for select groups. Includes coordination and reviewing formulary and pharmacy disruptions, analyzing for appropriate benefit design and pricing options, drafting/reviewing the RFP response, and ensuring professional packaging and deadlines are met. Responsible for follow up questions from consultants and/or prospective accounts, attends and participates in final sales presentations.
6. Directs and coordinates the transition of select groups including designing and developing non-standard literature, enrollment applications, member guides, Q&A’s, and other special marketing materials. Coordinates enrollment presentation to employees with agent and/or account. Represents Moda, conducting presentation of Moda’s pharmacy program to agents, clients and members. Schedules and leads internal transition meetings, ensuring the account transition to Moda is smooth and efficient. Maintains task lists and project plans for clients.
8. Will provide training to staff as assigned.
9. Performs other related duties as assigned.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
Please apply directly here: https://j.brt.mv/ATS/jb.do?reqGK=27317936&refresh=true
01. Bachelor degree required. Business, marketing, or related area preferred.
02. 5+ years experience in large account (3000+ members) Health / Pharmacy / PBM industry experience and/or training.
03. Demonstrated organization and leadership skills with the ability to prioritize in a dynamic environment.
04. Strong knowledge of Employee Benefits insurance. Ability to read, analyze and interpret industry policies and contract documents. Working experience with underwriting and pharmacy benefit / health plan development skills.
05. Excellent communication and presentation skills. Demonstrated experience working across organizations to accomplish business or client objectives.
06. Maintain a current Life & Health insurance license and/or other industry required licenses and certifications.
07. Strong statistical, analytical, problem solving, organizational, and detail orientation skills.
08. Self-motivated with the ability to work independently with limited supervision or within a group or team.
09. Understanding of Commercial, Medicare/EGWP, Medicaid markets and pharmacy contracts.
10. Proficient in Microsoft Office applications.
11. Presents a positive and professional image in the communities we serve.
12. Maintains a valid driver’s license and a good driving record.
13. Ability to handle a push cart/hand truck and be able to lift boxes up to 40 pounds in and out of a car trunk.
15. Ability to come into work on time and on a daily basis.
16. Ability to work well under pressure with frequent interruptions and shifting priorities.
Complete details: https://j.brt.mv/ATS/jb.do?reqGK=27317936&refresh=true