Client Pharmacist Drugs and Biologicals

Overview

The Client Pharmacist, Drugs and Biologicals will be responsible for supporting existing client growth and new sales activity by identifying value-creation opportunities with the D&B policy for our clients. This individual will be able to present policy to clients, utilizing data analytics while also acting as a liaison with our clients regarding D&B policy. Develop and support relationships at multiple levels with diverse business and client stakeholders; partner with the D&B content team to evaluate and validate editing; utilize in-depth knowledge of claim, claim adjudication, D&B policy edits and configuration.

Responsibilities

• Support existing client growth and new sales activity by identifying value-creation opportunities within the D&B policy for our clients
• Present appropriate D&B payment policy to clients for adoption based on review of data analytics
• Work alongside Medical Policy team to evaluate and validate editing
• Act as a liaison with our health plan clients regarding D&B policy
• Lend guidance and insight to the D&B content team based on client interactions and feedback.
• Have in-depth knowledge of claims, claims adjudication, D&B policy edits and configurations
• Inspire trust and credibility, deliver on commitments, provide value-add analytics
• Client Relationship Skills - Ability to develop strong professional relationships with multiple roles and levels, with focus on client pharmacy teams
• Comfortable with presenting to small and large groups of people
• Results driven with focus on producing high-quality, error free service and deliverables
• Working knowledge of drug database(s) such as FDB, Medispan, or Clinical Pharmacology
• Demonstrated ability to work with diverse business and client stakeholders.
• Intermediate to minimal guidance needed.

Qualifications

• Pharmacist (BS Pharm or PharmD)
• Valid Registered Pharmacist license required
• RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe (or willingness to obtain)
• 5 years in clinical, hospital, or retail setting as a pharmacist
• An additional 5 years of work experience for a health plan OR a minimum of 5 years in an internal Cotiviti role (CPM, CSM, Content Analyst)
• Strong analytical, critical thinking and problem-solving skills
• Proficiency in Microsoft Office Suite
• Excellent interpersonal, verbal and written communication skills

Job Demands

• Must have flexibility and willingness to participate in the work processes of an international organization
• After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent)
• Travel is required and varies throughout the year but could be up to 30% annually.

Base compensation ranges from $135,000 to $175,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

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