Account Manager, Payer Relations

Title: Account Manager, Payer Relations         Reports to: Director, Payer Relations

Location: Durham, NC or Pittsburgh, PA

Employment Status: Full Time Exempt

Position Summary:

Pharmacy Quality Solutions, Inc. (PQS), an expanding healthcare technology company involved in managing performance information related to the quality of medication use, is seeking a Payer Relations Account Manager to join the Payer Relations team. The manager will work with the Director of Payer Relations to manage the PQS efforts related to health plan and PBM customers. The account manager will lead PQS engagement projects and quality-based performance programs with payer clients in the managed care sector and maintain positive relationships with key accounts to ensure that customer needs are being met.

Specific responsibilities include:

  • Account Management
    • Build and maintain positive relationships with key managed care clients
    • Develop tailored approaches to manage relationships based on client needs
    • Includes visits to corporate headquarters for clients as well as frequent telephonic/email communications with clients
    • Manage efforts and projects developed between PQS and health plan/PBM clients
    • Provide routine analysis of quality measure performance to clients with actionable recommendations
    • Provide client-specific guidance, which includes meetings with a variety of management-level personnel within health plan and PBM organizations, on adoption of quality improvement processes that are enabled by EQuIPP™
    • Respond to client inquiries about EQuIPP™ and triage the inquiries to the appropriate PQS staff for follow up
    • Direct efforts to achieve project goals and identify barriers preventing achievement of goals
  • Cross-functional Collaboration
    • Work with internal PQS teams including the Information Services team regarding EQuIPP™ updates and support
    • Partner with internal PQS teams including and the Client Services team regarding client engagement and appropriate communication to EQuIPP end users related to payer programs, updates and support
    • Adopt and adhere to aspects of the Agile work process to ensure the proper and timely implementation of client development and work requests
    • Work collaboratively with all PQS team members as well as PQA and Premier staff to ensure that PQS’s mission and strategic plan are carried out successfully.
  • Expectations
    • Modest travel is required
      • Approximately 15-20% of time may be spent out of the office
      • At peak times may be several days in a row
    • Attend conferences and trade shows for managed care organizations. Exhibiting at national conferences is expected
    • Fulfill role and responsibilities at the highest ethical standards
    • Must be able to work under pressure and meet sensitive timelines
    • Ability to observe high levels of business protocol; maintain confidentiality, motivate, collaborate, multitask and prioritize projects and activities
  • Experience and Necessary Skill Requirements:
    • Bachelor’s Degree (advanced degree preferred)
    • Prior experience in account management, managed care contracting, or managed care network administration is preferred
    • 2+ years’ experience in a healthcare organization
    • Understanding of quality measurement systems (e.g., Medicare Stars, HEDIS) is a plus
    • Exceptional communication, presentation and writing skills
    • Excellent work ethic, including the ability to achieve with minimal supervision
    • Strong organizational, analytic, research and problem-solving skills
    • Proficient with the Microsoft Office Suite including high aptitude with Microsoft Excel

How to Apply: Resume and cover letter should be emailed to:

Pharmacy Quality Solutions is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.