Jobs at MedImpact Healthcare Systems

Acts as liaison between end users and IT to elicit, document, and translate complex business requirements into functional specifications. Leads projects, develops project plans, performs quality checks, manages service requests and releases, and supports development and QA. Facilitates design sessions, mentors junior analysts, and provides client-facing support for MedImpact products and services.

Manage onboarding and implementation of new PBM clients, coordinate cross-functional teams, ensure claims adjudication accuracy, document and test configurations, track project milestones in Salesforce, communicate client expectations, resolve issues, ensure regulatory compliance, and transition clients to maintenance while supporting process improvements and training.

Manage client relationships and implement clinical programs for PBM clients. Provide clinical guidance, develop strategies, analyze clinical data, report outcomes, ensure compliance, and collaborate cross-functionally to optimize clinical services and client satisfaction.

Lead client onboarding, implementation, and lifecycle management for PBM clients. Ensure service levels, resolve adjudication/configuration issues, coordinate cross-functional teams, track project deliverables, analyze claims, and drive client satisfaction, retention, and revenue growth.

Conduct independent clinical reviews for appeals, evaluate medical records and clinical criteria, make coverage determinations, document decisions, support guideline development, prepare reports and client communications, and assist with program improvement, utilization reporting, and P&T materials to ensure regulatory and client compliance.

The Account Executive manages client relationships, ensures deliverables meet quality and budget, develops strategic plans, and collaborates across teams to achieve business goals.

Lead and manage an account team for a state client, ensuring contractual compliance, program performance, and client satisfaction. Oversee cross-functional teams (Finance, Implementation, Call Center), drive growth and profitability, manage escalations, analyze claims and performance metrics, and coordinate regulatory, audit, and corrective action activities. Serve as primary client relationship lead and mentor staff.

Support Fee-For-Service Medicaid PA operations by creating and maintaining prior authorization guidelines, medication request forms, and electronic rules. Coordinate with clients and clinical teams, perform QA/testing, implement PA processes, and serve as a subject matter resource for PA guideline questions and documentation distribution.

Lead financial underwriting for new and existing clients by producing revenue estimates, P&L analysis, pricing and cost modeling. Develop pricing strategy, market and trend analyses, track bid activity, and advise on contractual language. Partner with sales, clients, and executives to optimize revenue and ensure pricing aligns with corporate objectives.

Lead enterprise pricing strategy and model governance across PBM lines of business. Align underwriting, network, rebate, and finance economics; monitor pricing outcomes, profitability, and KPI dashboards; drive pricing optimization and cross-functional initiatives with underwriting, trade, network, finance, clinical, and sales.

Lead underwriting for PBM clients by building revenue estimates, P&L analysis, pricing strategies, and market/trend modeling. Provide financial guidance for contracts, collaborate with sales and clients, track bid activity, identify cost drivers and process improvements to align opportunities with corporate strategy.

Lead development and management of rebate analytics and reporting strategies across the enterprise. Deliver pricing transformation, client-facing financial analysis, KPIs, stakeholder management, and supervise staff to ensure accurate, timely rebate and client financial reporting and strategic recommendations.

Lead underwriting and economic strategy for complex trade and emerging market initiatives. Develop business cases, financial models, pricing and margin analyses, and underwriting frameworks. Partner cross-functionally and with vendors to align contracts, implementation readiness, and performance tracking. Provide executive recommendations, run cross-functional workgroups, and manage a team with responsibility for coaching, prioritization, and performance management.

Manage Trade Emerging Markets activities across Trade Relations to assess pricing, rebate, reporting, and formulary impacts. Coordinate cross-functional stakeholders, track milestones and risks, document decisions, develop repeatable processes and communication, and supervise staff to ensure accurate, timely execution of emerging market product strategies and market-event responses.

Lead cross-functional trade and rebate-related initiatives, manage project planning and execution, ensure regulatory compliance, mitigate risks, drive process improvements, and supervise staff while engaging internal and external clients.

Lead rebate economics, pricing strategy, financial analytics, and client reporting. Partner with executive leadership and cross-functional teams to develop pricing methodologies, optimize revenue, mentor analytics staff, and support business growth through financial evaluation and strategic initiatives.

Process and finalize prior authorization requests per client guidelines and turnaround times. Use Windows-based systems and drug references to verify medications, document decisions, communicate with providers/pharmacies/members, resolve pended requests, and collaborate with clinical pharmacists and client teams to meet productivity and accuracy standards.

Lead clinical account management for state Medicaid pharmacy clients, optimizing drug utilization and net costs through evidence-based interventions, PDL and P&T support, utilization analyses, and coordination of clinical initiatives to meet client and company goals.

Lead territory sales activities to achieve revenue targets through prospecting, proposals, RFP management, pricing, negotiations, and onboarding. Build broker/consultant relationships, maintain CRM, collaborate cross-functionally (analytics, contracts, account teams), and represent MedImpact in the market to drive profitable growth and successful client implementations.

Lead an account team supporting a state client: ensure contract compliance, oversee cross-functional delivery (finance, implementation, call center), manage performance and escalations, analyze claims, drive process improvements and revenue growth, and supervise staff.