Clinical Account Manager

Abarca Health, LLC. • San Juan, PR • 1d ago

What you'll do In a few words... Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning... The Pharmacy Benefit Manager (PBM) Operations and Services team provides high quality services to clients and members by leading services from clinical programs, pricing, eligibility, configurations, and beneficiary services to government services and beyond. Our Clinical Services team is focused on helping our members get the pharmacy care they need. Our clinicians develop outcome driven clinical programs ensuring the quality of services is provided, develop comprehensive clinical coverage criteria and most importantly we have our clinical teams focus on clinical outreach programs to members, physicians, and pharmacies. As a Clinical Account Manager you will manage the clinical and client relationship component of your assigned accounts and clients' benefits, ensuring the highest level of service. The fundamentals for the job... Deliver custom clinical strategic plan designed to address clinical defined objectives. Recommend and oversee the implementation of appropriate Clinical Program & Services. Responsible for analyzing financial and utilization data to identify opportunities for improving care, controlling drug trend and overall healthcare costs. Evaluate Plan Design management opportunities, including formulary composition and management, utilization management, drug coverages, and prior authorization. Lead the annual clinical review, providing a comprehensive assessment of the drug benefit program from both a clinical and financial vantage point. Actively participates in Abarca P&T Committee meetings and client P&T meetings as per client contract, including provision of clinical material and expertise related to therapeutic class reviews, drug monographs, and drug information. Support the Business Development in RFPs, demos, and development of proposals related to clinical services. Support the tech division with clinical expertise. Other projects or duties as needed. What we expect from you The bold requirements... Doctoral Degree in Pharmacy is required. Current and Active Pharmacy License from Puerto Rico is required. 5+ years of clinical experience Experience with pharmacy benefit management, financial and clinical aspects of the benefit Experience with dashboard tools, such as Power BI and Excel tools. Experience with handling multiple projects at once in collaboration with internal and external stakeholders. Excellent verbal and written communication skills, bilingual Fluency in Spanish and English is required for this role. We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only). Physical requirements... Must be able to access and navigate each department at the organization's facilities. Sedentary work that primarily involves sitting/standing. At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca's workforce reflects the communities it serves. 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. Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. Applicant must be a United States' citizen. Abarca Health LLC does not sponsor employment visas at this time The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It's simply m

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