Costa Mesa, CA, 92627, USA
55 days ago
Senior Pharmacy Benefits Plan Consultant
Are you interested in working in a dynamic environment that offers opportunities for professional growth and new responsibilities? Are you interested in helping clients drive alignment with their business, improve organizational and human resource performance and establish a culture focused on adding business value? That is what the new generation of human resource transformation is all about. If you are seeking a role that offers you the opportunity to advise Government and Public Services (GPS) clients through critical and complex issues, while allowing you to develop personally and professionally, consider a career in Deloitte's Human Capital practice. Work you'll do + Conduct employee benefits diagnostic/planning studies, especially in pharmacy + Provide subject matter expertise on the pharmacy landscape, including emerging trends and cost drivers + Work directly with medical and PBM vendors to analyze the program offering and cost management solutions + Assist with preparing benefits plan design and pricing studies + Help conduct competitive vendor search and selection initiatives + Review of health plan renewals including assisting in rate negotiation, and analyzing financial terms for both medical and pharmacy + Assist with preparing financial projections and rate development + Review health plan performance, including reviewing policy year settlements and premium rate/administrative fee renewals + Assist in preparing client presentations and reports + Conduct other general health & welfare consulting activities, as required + In addition to serving plan sponsors, other project work can include working with payers and providers in such projects as provider network development, operational claim reviews, etc. The team Deloitte's Government and Public Services (GPS) practice - our people, ideas, technology and outcomes-is designed for impact. Serving federal, state, & local government clients as well as public higher education institutions, our team of over 15,000+ professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise. The Workforce Transformation (WFT) offering helps clients consider how work, workforces and workplaces need to be reimagined in the service of future business strategy. We collaborate with clients to evaluate the nature of work, how the composition of the workforce will evolve to meet business needs, and how to activate next generation leaders, learning, skills, and incentives for the future. Qualifications Required: + Bachelor's Degree + 5+ years' experience in employer health plan consulting + 1+ years experience reviewing health plan performance + 1+ years experience preparing financial/budget projections + Proficiency with MS Office products, including Word, Excel, PowerPoint + Must be able to obtain and maintain the required clearance for this role + Ability to travel 25-50%, on average, based on the work you do and the clients and industries/sectors you serve + Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future Preferred: + Prior professional services or federal consulting experience + 6+ years of health plan/insurance/pharmaceutical company and/or consulting experience + Technical background in underwriting and other areas of health care finance + Strong understanding of health care plan design and alternative delivery systems, including consumer directed health plans with HRAs and HSAs + Knowledge (plan design and pricing) of other health & welfare benefit plans (e.g., life, disability, dental, etc.) + Technical background in underwriting and other areas of health care finance + CEBS Designation or Actuarial credentials. In-depth experience with healthcare and pharmacy benefit management, including: + Experience performing vendor selection reviews for Self-insured Health plans administrators and PBMs + Experience performing hospital / physician network discount and network disruption analyses + Experience with evaluating the pricing arrangements for PBMs contracts, including evaluation of disruption related to formulary changes + Experience reviewing and negotiating pharmacy contracts (pricing and business terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims, including understanding financial impact of network changes, design changes and formulary changes + Understanding of healthcare landscape, including up and coming trends in medical and pharmacy For individuals assigned and/or hired to work in California Deloitte is required by law to include a reasonable estimate of the compensation range for this role. This compensation range is specific to California, Colorado, Hawaii, Jersey City, Nevada, New York state, and Washington state and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $97,875 - $163,125 You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.
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