Clinical Account Manager - PBM

Capital Rx is seeking a strategic, client-focused professional to lead and develop strong relationships with key decision-makers in the healthcare space. In this role, you'll oversee account management, ensuring client satisfaction, retention, and trend management, while analyzing pharmacy data to provide actionable insights. You’ll collaborate with clients to develop clinical strategies, execute contract renewals, and contribute to process improvements. If you’re passionate about delivering exceptional service and driving healthcare innovation, we’d love to hear from you!

Position Responsibilities:

• Establish and develop relationships with key client decision-makers, understand their healthcare strategy and goals, determine how Capital Rx can best help them achieve their desired results
• Provide oversight of client account management team with a focus on member and client satisfaction, trend management, and client retention
• Partner with account team members to provide best-in-class member and client service
• Support member issue resolution at client-level
• Identify and contribute to process improvement efforts within the team
• Responsible for management and execution of client contractual requirements
• Responsible for client retention including execution of contract renewals
• Analyze and interpret pharmacy claims data to identify clinical trends and insights for individual clients
• Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for clinical management strategies
• Interpret current pharmacy and healthcare trends and provide proactive recommendations
• Incorporate treatment & practice guidelines, clinical education, and pharmacy pipeline details into client presentations
• Comprehend and effectively explain formulary and clinical programs to clients, including member experience
• Communicate drug information to clients and respond to plan-specific clinical inquiries
• Analyze and evaluate pharmacy benefit reporting and create ad-hoc reports as requested
• Build and manage strong relationships with third-parties who also service our clients
• Support general business needs and operations, as required
• Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution, with record of strong academic performance
• Relevant experience for at least three (3) years in pharmacy - health plan, managed care, or pharmacy benefits management (PBM) experience preferred; or completion of managed care residency
• Prior account management experience preferred
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel
• Experience working with large datasets and analyzing raw data in Excel
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high quality work product
• Ability to travel and present to small and large groups
• Travel estimated not to exceed 25%

Base Salary: $130,000 - $150,000

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Salary : $130,000 - $150,000