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Pharmacy Benefit Business Advisor

Company: Horizon Blue Cross Blue Shield
Location: Newark
Posted on: June 9, 2021

Job Description:

Job Summary:

The Pharmacy Benefits Business Advisor: This position develops and executes strategies to grow pharmacy enrollment and improve retention, increase adoption of Horizon pharmacy and ancillary services, and to meet financial targets. This position is the primary representative of Horizon to multiple existing employer Administrative Services Only (ASO) accounts and will optimize the pharmacy revenue for the ASO market through use of Horizon products and services.

Responsibilities:

  • Advises on overall P&L for ASO pharmacy business via collaboration with Commercial Business Unit leadership team to establish annual membership and revenue targets and their ongoing performance.
  • Accountable to design, refine, and maintain a monthly scorecard to report on win-loss rates, underwriting margin, membership and financial goals, forecasting and modeling.
  • Partners with the Commercial Business Unit to regain lives that have been carved-out, winning new business, and assisting the account management team in retaining current business through the adoption of new and existing products and services, cross selling of other Horizon program and product offerings.
  • Educates and collaborates with the underwriting team on client contracting strategy and establishing rules of engagement for the market, and ensuring contract terms align with proposal parameters.
  • Educates leadership team, marketing, underwriters, and account management teams on current topics in the industry, new product developments, Horizon Pharmacy program offerings and solutions, and the competitive landscape. -Create, manage, and review pricing offers do drive pharmacy membership growth and program adoption while ensuring overall revenue goals are met.
  • Continuously monitor performance to identify risks and solutions to optimize financial performance.
  • Develops the pharmacy value proposition, tools and collateral for business growth and retention.
  • Lead RFP activities and develop the strategy to meet proposal requirements via leveraging an in-depth understanding of the needs of the market, various consultants, and prospective groups.
  • Forge strong broker and consultant relationships to meet market demands.
  • Conducts the review of requests for underwriting exceptions, as needed.

The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.

Knowledge/Skills/Abilities:

  • Able to communicate and demonstrate a comprehensive knowledge of Horizon, products and services to the market.
  • Proficient in MS Office suite (Excel, Word, Powerpoint).
  • Is highly analytical and has experience with creating financial models.
  • Requires demonstrated aptitude for analytical thinking including the ability to research and resolve problems, report findings accurately, identify solutions and implement resolutions through interaction with company-wide personnel.
  • Ability to establish and maintain collaborative relationships with analytic and non-analytic business partners, and external partners, and all levels of management in order to elicit business needs and drive results.
  • Requires the ability to plan, organize and prioritize diverse and complex work assignments.
  • Excellent communication, presentation, and collaboration skills.
  • Exercises sound business judgment and has strong attention to detail.

Education:

  • Bachelor's Degree required, Master's Degree is desirable

Experience:

  • Requires a minimum of 7 years of professional experience in Pharmacy Benefit Management
  • Prefers strong financial experience
  • Prefers experience in financial analysis
  • Prefers experience in Pharmacy Benefit Sales.
  • Prefers experience with underwriting or pricing analytics at a PBM or Health Plan is a plus.
  • Prefers comprehensive understanding of the Pharmacy Benefit Manager landscape.

Travel % (If Applicable):

  • 15% to 25% locally

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.

Keywords: Horizon Blue Cross Blue Shield, Newark , Pharmacy Benefit Business Advisor, Other , Newark, New Jersey

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