If you’re looking for a career that provides affordable health benefit solutions to the people who support some of the most vital industries, we’re looking for you.        At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management.  We are also a proud contracted partner with Covered California. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees.        As a keystone of our philosophy, we recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Additionally, employees are encouraged to recognize that there isn’t a work life and a home life, there is one life. This recognition throughout the organization emphasizes the value of finding a healthy and happy balance in every employee’s life. One way this is realized for employees of Pinnacle Claims Management is flexible work arrangements with work-from-home, in-office or hybrid options.        With competitive compensation packages, premier investment support, enriching personal development and more, we strive for our employees’ job satisfaction and success.           Compensation:  $70,978.23- $97,271.29 with a rich benefits package that includes profit-sharing.          

Job Description Summary

This position reports to the Senior Director, Client Services and México Operations for Pinnacle Claims Management (PCMI) and is responsible for managing customer accounts during and following the sale of employer benefit programs and services including Pinnacle third party administration (TPA), Pinnacle Rx Solutions (PRxS), Pinnacle Health Management (PHM), and complete ancillary benefits offered by PCMI vendor partners including the Western Growers Insurance Services (WGIS) employer benefit programs.  The Account Manager working in collaboration with internal operation and administration departments will help coordinate and assist in pre and post-sale implementation and plan support of the customer’s account. Position also supports new sales expansion activities through cross sale initiatives.

Qualifications

• BA/BS and three to five years of direct Account Management and service experience in a TPA organization, employer health benefits, and employee health care benefits preferred. 
• Exceptional expertise working in a TPA and employer health benefits market and its relative services, policies, common practices, and procedures.
• Considerable knowledge of Pharmacy Benefit Manager (PBM) operations and customer care, preferred.
• Significant knowledge of Wellness and Disease Management programs, preferred.
• Advanced personal computer operation skills in various software applications including word processing, spreadsheet, electronic mail and presentation.
• Considerable composition and writing skills including grammar, spelling and proper use of punctuation.
• Excellent verbal communication skills with the ability to maintain strict confidentiality on matters relating to protected health care information.
• Excellent organization skills, attention to detail with high degree of accuracy, and the ability to work independently and exercising judgement. 
• Ability to meet deadlines under pressure.
• Ability to analyze information and evaluate results to choose the best solution.
• Active Life & Health insurance license in California. 
• Verifiable, clean DMV record and the ability to travel up to 30% of the time to locations throughout the US (mainly California and Arizona).

Duties And Responsibilities

Account Management

• Responsible for the overall servicing of their overall book of business under the PCMI platform.
• Provides day-day administration and delivering on the needs of the clients and brokers as it relates to Pinnacle TPA, PRxS, PHM and ancillary products.
• Supports and advises clients and brokers on self-funding, pharmacy benefits management, care management and utilization review, wellness, stop loss and print and distribution.
• Maintains client reference files on server for all assigned accounts, detailing past work and work-in-progress, and all pertinent information as it relates to meeting the customer’s/broker’s needs.
• Monitors projects to ensure they proceed according to plan and deadlines