Clinical Consultant

Who We Are:   

NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com. 

 

Position Overview:

The Clinical Consultant position serves as a valued member of Valued Pharmacy Services (VPS). This role directly supports the pharmacy benefit consulting team through all phases of the business. The Clinical Consultant role is responsible for providing clinical assessments of assigned clients plan performance, identifying plan utilization trends or concerns, and providing comprehensive clinical recommendations for the plan to help reduce plan cost while optimizing member health outcomes. Coordinates VPS services to assigned clients, while representing the clients’ interests with the providers, and serving as the clients’ liaison to providers and other internal and external partners. The Clinical Consultant also plays a major advisory role, by providing client consultation regarding clinical opportunities, emerging trends, and best practices.

This position also assists in the education of the internal staff to advance VPS’ efforts to increase value by providing innovative cost-effective solutions that help maximize the client’s effort to provide an affordable pharmacy benefit while minimizing disruption to the member and improving health outcomes. 

 

Principal Duties and Responsibilities / Essential Functions:

1. Develop and maintain effective working relationships in a clinical liaison role between clients and internal and external partners, such PBMs, brokers, and other account staff.
2. Communicate with external clients and brokers with clinical insights and clinical program recommendations
3. Responsible for understanding each assigned client’s business model and organizational structure and keeping in the loop on client news and changes.
4. Review of claims processing, benefit designs, and financial reports, etc., to ensure they represent the client’s interest.
5. Represent company as a clinical pharmacy benefit subject matter expert at conferences which may include public speaking events
6. Engage with clients and brokers to assist in the resolution of all clinically related service problems.
7. Serve as liaison to VPS’ PBM partners to resolve problematic clinical issues
8. Make regular service/relationship calls to clients; establish and promote goodwill with customer.
9. Review client history and follow up with client on a regular basis.
10. Host clients in the VPS and/or carrier facilities, as needed.
11. Prepare reports deemed necessary by the leadership and/or broker.
12. Keep all information on accounts accurate and up to date in the Zoho CRM software or any other client management software that is introduced in the future.
13. Meet or exceed departmental goals established by leadership.
14. Keep industry skills and knowledge current by participating in seminars and classes for continuing education.
15. Assist with the development of job aids, training materials, etc.
16. Present a positive image of self and of VPS, in and out of the office, to fellow employees, clients, providers, and the community.
17. Conduct special projects at the request of the leadership.
18. Perform related and/or other duties as assigned.

 

Minimum Requirements for Education, Experience, and Certifications/Licenses:

• Licensed pharmacist in any state. Preferably a PharmD.
• Prefer 2+ years’ experience in clinical consulting. Preferably with a PBM or Health System.

 

Qualifications & Skills:

1. Understanding of the Employee Benefits industry, and PBM specifically
2. Knowledge in pharmaceutical clinical review practices
3. Excellent research skills
4. Ability to read, analyze and interpret industry policies and contract documents, as well as proposals and other documentation and correspondence
5. Ability to respond efficiently and accurately to common inquiries or complaints from customers or carrier
6. Ability to effectively present information to insured clients and their respective carriers
7. Ability to create effective clinical programs for clients
8. Excellent oral and written communication skills and command of the English language
9. Ability to apply basic mathematical concepts such as percentages, adding, subtracting, multiplying and division to required tasks
10. High degree of critical thinking, organizational and decision making skills
11. Ability to define problems, collect and analyze data, establish facts, and draw valid conclusions
12. High degree of initiative
13. High degree attention to detail
14. Ability to function independently with minimal supervision
15. Ability to prioritize multiple projects and meet objectives and deadlines established by supervisor and clients, often with short turnaround times
16. Ability to maintain positive and beneficial relationships with department staff, numerous internal departments, external customers, agents, and subscribers
17. Proficient in MS Excel, Word, Outlook, and PowerPoint
18. Professional telephone skills and e-mail etiquette
19. Ability to comply with company confidentiality requirements as well as with HIPAA and other applicable government regulations

 

Travel: 

This position requires travel up to 10% of the time, with occasional overnight trips.

 

Physical Demands:

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

1. Able to lift and carry 15 pounds
2. Able to work at a desk using computer equipment up to 95% of the time
3. Frequent telephone use

NOTE:

The information in this job description indicates the general nature and level of work performed by employees in this classification. It is not a comprehensive list of all duties, responsibilities and/or qualifications required of employees assigned to this position.

 

What We Offer: 

We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others. The base salary range for this position is $111,000.00 – $150,000.00. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. 

 

NFP and You... Better Together! 

NFP is an inclusive Equal Employment Opportunity employer. 

Provides commercial insurance brokerage and employee benefits consulting.