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Director, Clinical Account Management

Director, Clinical Account Management

Apex BenefitsIndianapolis, IN, United States
7 hours ago
Job type
  • Full-time
Job description

Are you interested in joining a successfully growing organization that has been recognized for over a decade as a Best Place to Work, recipient of Healthiest Workplace awards, and The Platinum Bell Seal for Workplace Mental Health? If so, come join our Innovative Rx Strategies team of clinical experts!

Our team is uniquely qualified to serve employers, benefits brokers, TPAs, health care systems and health plans with deep understanding of the pharmacy benefits markets and health care industry trends. With expert knowledge we are committed to one mission - breaking down a complex industry to save our clients' money on their benefits programs and manage their cost trends.

As a rapidly growing organization, IRxS is distinguished by its commitment to advocating for clients both personally and financially while delivering measurable cost savings for employers and their employees.

Innovative Rx Strategies is an Apex Benefits Group, Inc. (ABG) company. ABG offers competitive benefits, flexible hybrid work model, paid time off, a collaborative team environment, and advanced training and development.

Job summary

The Director, Clinical Account Management develops and executes the strategy to provide overall day-to-day clinical consulting and account management to ensure the effective execution of client objectives and the PBM contract. This role is ideal for a strategic, client-focused professional with deep expertise in pharmacy benefits and healthcare consulting. The position blends account management, data analysis, vendor oversight, and clinical advisory services to deliver high-impact solutions for employer-sponsored health plans. You'll lead client engagements, interpret complex benefit designs, monitor pharmacy performance, and guide decision-making around high-cost drugs and formulary strategy. With responsibilities spanning compliance, channel strategy, and PBM coordination, this role offers a dynamic opportunity to shape pharmacy benefit outcomes across diverse employers.

Summary of essential job functions / responsibilities

Account Management

  • Coordinate meetings, agendas, and follow-up action items related to pharmacy benefit activities
  • Deliver exceptional customer service, including interpreting plan designs, resolving claims and member issues, and addressing benefit and enrollment inquiries
  • Conduct routine onsite account visits as needed
  • Monitor compliance and legislative changes, advising clients and ensuring adherence to regulatory requirements

Data Management

  • Lead data assessments, trend analysis, and reporting for clients
  • Present routine trend reports and annual performance reviews
  • Plan and execute annual reconciliation and market check processes
  • Collaborate with clinical and analytics teams to monitor pharmacy claims performance, identifying opportunities to enhance benefits, close clinical gaps, and drive cost savings
  • Vendor Management

  • Ensure vendors meet client-specific needs and timelines
  • Interface with PBM operations to resolve issues efficiently
  • Support implementation of new PBMs, programs, and services
  • Provide clinical insight during vendor evaluations and the selection of pharmacy benefit managers and consulting solutions
  • Clinical & Advisory Services

  • Make informed decisions considering 340B status and pricing implications
  • Manage custom client-facing formularies
  • Support Pharmacy & Therapeutics (P&T) initiatives focused on employer benefits
  • Navigate the financial complexities of owned-entity pharmacies
  • Advise clients on new-to-market and high-cost drugs, including cost-saving strategies for A / C / J / Q codes and other medical benefit medications
  • Minimum requirements

  • Pharmacy degree required; PharmD or Pharmacy Residency preferred
  • A minimum of 5 years of practical pharmacy experience required or equivalent with a managed care pharmacy residency; previous PBM or Pharmacy Benefit experience preferred.
  • Knowledge of current business and industry trends
  • Superior problem solving, analytical ability, attention to detail and customer service skills
  • Positive attitude, willingness to learn and interest in working towards team goals
  • Relationship builder
  • Excellent organizational and time management skills
  • Highly developed reasoning and problem-solving skills
  • Strong verbal communication skills, with ability to present in person with clients and prospects
  • Self-motivated, with ability to meet deadlines; ability to work productively and proactively
  • Ability to plan, organize, and work on multiple tasks simultaneously and exercise independent judgement
  • Proficient in Excel, Word, PowerPoint, and other analytic tools that may be introduced
  • Abide by all obligations under HIPAA related to Protected Health Information (PHI) and Capable of maintaining confidential information
  • Physical Demands and Work Environment

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

  • Must be able to communicate extensively and effectively with staff and vendors via telephone / TDD, one-on-one conversations, face-to-face, public presentations, and written correspondence
  • Must be able to process and maintain large volumes of documentation, email and other related tools related to the role. Requires extensive use of keyboards and other administrative equipment.
  • Must be able to sit or stand for extensive periods of time and navigate through the office
  • Must be able to function within a moderate noise level office environment
  • Ability to travel to and work in the corporate office located in Indianapolis, Indiana is required, in addition to client locations.
  • Disclaimer

    The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

    Additional Information

    Apex Benefits Group, Inc. demonstrates equal opportunity employment and does not discriminate based on age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability, or any other legally protected status.

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