AffirmedRx, PBC Benefits Overview

Serves as the primary operational contact for assigned employer and health plan clients. Coordinates benefit administration, eligibility updates, plan changes, implementations, renewals, reporting, and issue resolution across internal teams. Maintains client records, supports meetings and business reviews, monitors pharmacy spending and utilization, identifies optimization opportunities, and communicates pharmacy benefit guidance clearly. Ensures accurate follow-through, regulatory compliance, client satisfaction, and continuous process improvement.

Leads a specialized data operations team supporting PBM client eligibility and accumulator data. Owns file layouts, data mapping, SFTP transmissions, coding automations, monitoring, change control, and data integrity. Applies hands-on claims adjudication expertise to troubleshoot issues and support client onboarding and escalations. Serves as Scrum Master, manages team performance, coordinates cross-functional priorities, and improves operational processes. Requires direct client communication and 10%–20% travel.

Drives revenue growth and market expansion for a pharmacy benefits management company. Manages the full sales cycle, identifies prospects through broker, consultant, and employer relationships, oversees RFPs and finalist presentations, delivers sales presentations, negotiates contracts, and strengthens strategic partnerships. Collaborates with marketing, operations, proposals, underwriting, implementation, and client management teams. Requires extensive healthcare or pharmaceutical sales experience, strong PBM knowledge, and up to 50% travel.