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Pharmacy Benefits Plan Consulting Manager

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Deloitte

2mo ago

  • Job
    Full-time
    Senior & Expert Level
  • Arlington

AI generated summary

  • You need a Bachelor's, 8+ years in health plan consulting, proficiency in MS Office, expertise in pharmacy benefits, analytical skills, and relevant healthcare finance experience.
  • You will lead pharmacy benefits studies, analyze vendor offerings, negotiate renewals, prepare financial projections, and conduct consulting activities for health and welfare plans.

Requirements

  • Bachelor's Degree
  • 8+ years' experience in employer health plan consulting
  • 1+ years experience reviewing health plan performance
  • 1+ years experience preparing financial/budget projections
  • Proficiency with MS Office products, including Word, Excel, PowerPoint
  • Must be able to obtain and maintain the required clearance for this role
  • Ability to travel 25-50%, on average, based on the work you do and the clients and industries/sectors you serve
  • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
  • Prior professional services or federal consulting experience
  • 14+ years of health plan/insurance/pharmaceutical company and/or consulting experience
  • Technical background in underwriting and other areas of health care finance
  • Strong understanding of health care plan design and alternative delivery systems, including consumer directed health plans with HRAs and HSAs
  • Knowledge (plan design and pricing) of other health & welfare benefit plans (e.g., life, disability, dental, etc.)
  • Technical background in underwriting and other areas of health care finance
  • CEBS Designation or Actuarial credentials
  • In-depth experience with healthcare and pharmacy benefit management, including:
  • Experience performing vendor selection reviews for Self-insured Health plans administrators and PBMs
  • Experience performing hospital / physician network discount and network disruption analyses
  • Experience with evaluating the pricing arrangements for PBMs contracts, including evaluation of disruption related to formulary changes
  • Experience reviewing and negotiating pharmacy contracts (pricing and business terms) with PBMS
  • Experience performing analytical analysis of medical & pharmacy claims, including understanding financial impact of network changes, design changes and formulary changes
  • Understanding of healthcare landscape, including up and coming trends in medical and pharmacy

Responsibilities

  • Lead employee benefits diagnostic/planning studies, especially in pharmacy
  • Provide subject matter expertise on the pharmacy landscape, including emerging trends and cost drivers
  • Work directly with medical and PBM vendors to analyze the program offering and cost management solutions
  • Own the process of preparing benefits plan design and pricing studies
  • Implement competitive vendor search and selection initiatives
  • Review of health plan renewals including assisting in rate negotiation, and analyzing financial terms for both medical and pharmacy
  • Prepare financial projections and rate development
  • Review health plan performance, including reviewing policy year settlements and premium rate/administrative fee renewals
  • Prepare client presentations and reports
  • Conduct other general health & welfare consulting activities, as required
  • In addition to serving plan sponsors, other project work can include working with payers and providers in such projects as provider network development, operational claim reviews, etc.

FAQs

What is the main focus of the Pharmacy Benefits Plan Consulting Manager role?

The main focus is to lead employee benefits diagnostic/planning studies related to pharmacy, provide subject matter expertise on the pharmacy landscape, and assist clients in optimizing their health plan performance and cost management solutions.

What qualifications are required for this position?

A Bachelor's Degree, 8+ years of experience in employer health plan consulting, 1+ year reviewing health plan performance, experience preparing financial/budget projections, proficiency with MS Office, the ability to obtain required clearance, and legal authorization to work in the U.S. without sponsorship.

Is travel required for this role?

Yes, the role requires the ability to travel 25-50%, on average, depending on the work and the clients served.

What are some preferred qualifications for this position?

Preferred qualifications include prior professional services or federal consulting experience, 14+ years in health plan/insurance/pharmaceutical company and/or consulting experience, a strong understanding of health care plan design, and CEBS designation or actuarial credentials.

What does the Workforce Transformation (WFT) offering focus on?

The Workforce Transformation offering focuses on helping clients reimagine how work, workforces, and workplaces align with future business strategies to meet evolving needs.

What type of experience is valued in healthcare and pharmacy benefit management for this role?

In-depth experience is valued, such as performing vendor selection reviews, evaluating pricing arrangements for PBM contracts, negotiating pharmacy contracts, and understanding the financial impact of network, design, and formulary changes.

What is the compensation range for this role if hired in California?

The compensation range for this position is estimated to be between $131,175 and $218,625, dependent on factors such as skill sets, experience, and organizational needs.

Are there opportunities for professional growth in this role?

Yes, the position offers opportunities for professional growth, new responsibilities, and personal development in a dynamic environment.

Does Deloitte offer any incentive programs for employees?

Yes, employees may be eligible to participate in a discretionary annual incentive program based on individual and organizational performance, subject to the program's rules.

Is there assistance available for applicants with disabilities?

Yes, information and accommodations are provided for applicants with disabilities. More details can be found on Deloitte's careers page dedicated to assistance for disabled applicants.

Consulting
Industry
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Employees
1845
Founded Year

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