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Edgewood Partners Insurance CenterEC

Pharmacy Benefit Consultant, Health Plan

EPIC is a leading retail risk management and employee benefits brokerage, dedicated to delivering innovative solutions to clients across the United States.

Edgewood Partners Insurance Center

Employee count: 1001-5000

Salary: 180k-200k USD

United States only

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For over 20 years PSG (an EPIC owned company) has been singularly focused on helping our clients navigate the complex and ever-changing challenges of drug management. Through our leading pharmacy intelligence and technologies, we save our clients billions of dollars every year with an unwavering commitment to serving as the plan’s advocate and strategic partner.
Our mission is to relentlessly advocate for our clients as we partner together to develop innovative drug management solutions that deliver exceptional strategic insights, financial and clinical value.
The Pharmacy Benefit Consultant - Health Plans will serve as primary and lead consultant on strategic clients’ projects with a focus on national and regional health plans. Lead and cultivate multi-level client relationships with senior executives, pharmacy department leadership and personnel, sales and product leads, clinical management and others which enable PSG to partner with clients to create, communicate and implement pharmacy strategy within the context of the overall healthcare strategy. Identify business needs and create custom solutions for sophisticated clients which include overall pharmacy benefit and medical management initiatives to address the overall goal of healthcare affordability. Lead vendor (PBM) strategies that will include procurement efforts, contract negotiation and ongoing vendor management. Provide industry expertise and insight related to cost and trend management opportunities.

Responsibilities include:

Client Management

• Identify and maintain appropriate multi-level client relationships and a deep understanding of client business and corporate culture resulting in high client satisfaction and retention rates.
• Develop and implement customized strategic plans based on unique client needs to achieve targeted long- and short-term goals.
• Track and measure vendor contract performance including operational and financial measures.
• Lead and participate in ongoing client meetings including vendor review meetings and independent strategy and performance assessment meetings
• Identify opportunities to engage internal PSG experts on custom projects and analyses.
• Review pharmacy program indicators for ongoing opportunities and program performance measures.
• Maintain ongoing reports and documentation related to client relationships and program performance.
• Responsible for renewal of client relationship and creating strategy, scope of services and appropriate fee structure to match client needs.

Program and Business Development

• Assess opportunity for expanding PSG services within existing client relationship.
• Leverage client relationship for PSG prospecting efforts by creating developing client reference.
• Participation in conferences and other forums for showcasing program experience and success.
• Participate in internal workgroups to develop new programs, services, corporate positions and publications based on the continual assessment of client and market needs.

Account Implementation

  • Provide oversight, guidance and serve as an advocate for the client to ensure vendor requirements are met and service levels are adequate throughout vendor implementation.
  • Identify issues and concerns for appropriate escalation and resolution to ensure successful transition.

RFP Process Management

• Lead the development and management of the RFP process for clients including RFP creation, vendor selection meetings and contract execution (in conjunction with internal RFP coordinator).
• Participate in non-client RFP process via scoring and client meeting assistance.

• Contract Review and Execution

• Lead the review process for new and renewing vendor contracts through final execution to ensure current terms, definitions and compliance with RFP requirements.
• Lead the creation and renewal of PSG client agreements to create appropriate scope of services and fee structure.

Qualifications (Minimum Requirements)

• Extensive knowledge of PBM, specialty pharmacy or managed care environments (5-7 years minimum experience).
• Strong verbal and written communication skills including presentation skills and client relationship management experience.
• Ability to develop strategies and implement programs for large client Rx and medical benefit programs
• Strong clinical and financial analysis skills including Word, PowerPoint and Excel
• Pharmacy background with bachelor’s degree; MBA or PharmD/RPh strongly preferred
• Business development experience preferred

Salary and Benefits
Salary is based on background and experience. Benefits include full medical, pharmacy, dental, vision, life and disability insurance, paid vacation, sick leave, 401k match and annual bonus potential.
The national average salary for this role is $180k to $200k in base pay and exclusive of any bonuses or benefits. The base pay offered will be determined based on your experience, skills, training, certifications, and education, while also considering internal equity and market data.

WHY EPIC:

EPIC has over 60 offices and 3,000 employees nationwide – and we’re growing! It’s a great time to join the team and be a part of this growth. We offer:

  • Generous Paid Time off
    • Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days
  • Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave
  • Generous employee referral bonus program of $1,500 per hired referral
  • Employee recognition programs for demonstrating EPIC’s values plus additional employee recognition awards and programs (and trips!)
  • Employee Resource Groups: Women’s Coalition, EPIC Veterans Group
  • Professional growth & development: Mentorship Program, Tuition Reimbursement Program, Leadership Development
  • Unique benefits such as Pet Insurance, Identity Theft & Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause & Midlife Support
  • Additional benefits include (but are not limited to): 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness & employee assistance programs
  • 50/50 Work Culture: EPIC fosters a 50/50 culture between producers and the rest of the business, supporting collaboration, teamwork, and an inclusive work environment. It takes both production and service to be EPIC!
  • EPIC Gives Back – Some of our charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation
  • We’re in the top 10 of property/casualty agencies according to “Insurance Journal”

To learn more about EPIC, visit our Careers Page: https://www.epicbrokers.com/about/epic-careers/.

EPIC embraces diversity in all its various forms—whether it be diversity of thought, background, race, religion, gender, skills or experience. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard. It is our belief that diversity drives innovation and that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients.
California Applicants - View your privacy rights at: https://www.epicbrokers.com/wp-content/uploads/2025/01/epic-ca-employee-privacy-notice.pdf.

#PSG

About the job

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Job type

Full Time

Experience level

Salary

Salary: 180k-200k USD

Education

Bachelor degree

Experience

5 years minimum

Location requirements

Hiring timezones

United States +/- 0 hours

About Edgewood Partners Insurance Center

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EPIC Insurance Brokers & Consultants is a unique and innovative retail risk management and employee benefits brokerage and consulting firm, established in 2007 in San Francisco, California. With a focus on delivering top-tier risk management solutions, EPIC offers a broad array of insurance services ranging from employee benefits consulting to comprehensive risk management strategies. Our commitment to innovation allows us to provide customized insurance solutions that meet the unique needs of our clients while effectively managing associated risks.

Powered by over 3,000 dedicated team members across the United States, EPIC is rapidly becoming a leader in the insurance sector. With a run-rate revenue exceeding $1 billion, we pride ourselves on our ability to adapt and respond to the evolving landscape of insurance. Our clients, which include more than 100,000 businesses, benefit from our deep industry expertise and personalized service model. We believe that effective risk management is the cornerstone of business resilience and growth, and we are devoted to helping our clients navigate complex insurance challenges with customized, strategic solutions.

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