Senior Account Manager
Description
J O B D E S C R I P T ION SUMMAR Y
Position reports to Pinnacle Claims Management (PCMI) Director, Client Service and México Operations and coaches existing account management staff responsible for supporting customers, as well as is responsible for managing customer accounts during and following the sale of employer benefit programs and services including third party administration (TPA) health care benefits, complete ancillary benefits offered by PCMI vendor partners including Western Growers Insurance Services (WGIS) employer benefit programs. The Senior Account Manager working in collaboration with internal operation and administration departments will help coordinate and assist in “after-the-sale” implementation and plan support of the customer’s account. Position also supports new sales expansion activities. Position helps in handling escalated account issues. Position grows existing account base by renewing contracts, uncovering new user groups, cross selling and upselling.
This position is the critical link between internal service teams and business partnerships with customers. This position possesses strong analytical skills in account tracking. The Senior Account Manager provides the account management team with direction and an experience resource.
QU A L I F I C A T IONS
BA/BS and five to ten years of direct Account Management and service experience in 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.
Demonstrated skill in health plan analysis and ability to present recommendation to clients/brokers.
Considerable knowledge of Pharmacy Benefit Manager (PBM) operations and customer care,
preferred.
Significant knowledge of Wellness and Disease Management programs, preferred.
Thorough knowledge of ACA and federal benefit laws, practices and duties performed with little to no
supervision.
Experience with major accounts and strong understanding of various funding vehicles available to large
employers required.
Demonstrated strong relationship management experience with knowledge and experience in the area
of benefit consultation and strategic planning.
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, written and presentation communication skills suitable for executive audiences 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 judgment.
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 to various locations throughout the U.S. (mainly
California and Arizona) up to 30% of the time.
Strong category and relationship management skills with experiences in managing and working with
Vendors and Service Providers.
Excellent business acumen and commercial skills including negotiation skills, both tactically and
strategically.
Strong leadership, coaching, organizing, project management and communication skills.
D U T I E S A N D R E S PON S I B I L I T I E S
Account Management
Evaluate and plan account management assignments to make the most efficient use of internal operation
and administration team strengths and weaknesses to ensure client delivery commitments are met.
Provide strategic, consultative support to brokers and clients.
Identify strong internal and external vendor talent and best practices to ensure client satisfaction and
future renewals.
Aid in preparation of Account Management department's annual budget based on book of business,
expectations to retain and grow.
Supports and advises clients and brokers on self-funding, pharmacy benefits management, care
management and utilization review, wellness, stop loss and print and distribution.
Conduct regular employer client process analysis focusing on opportunities to drive results such as
process improvements, expectations management, key issues and resolutions.
Utilize broad knowledge of health and wellness employee benefits to instill confidence with decision
makers and key stakeholders during service interactions.
Update job knowledge by participating in educational opportunities, reading professional publications,
maintaining personal networks, and participating in professional organizations.
Accomplish organization goals by accepting ownership for accomplishing new and different requests, and
exploring opportunities to add value to job accomplishments.
Responsible for the overall servicing of the overall book of business under the PCMI platform.
Provides day-to-day administration and delivering of the needs of the clients and brokers as it relates to
Pinnacle TPA and its ancillary products.
Manage client relationships and promote timely resolution of client issues. Interface with appropriate
departments and orchestrate resources to handle customer service issues.
Maintains client reference file on server for all assigned accounts, detailing past work, and work inprogress,
and all pertinent information as it relates to the meeting of customer’s/broker’s needs.
Monitors projects to ensure they proceed according to plan, deadlines, and identifying potential problems
before they occur.
Implement renewal and retention strategy for all clients by extracting key information, discussing current
and prospective client operations, and presenting informed recommendations for health and ancillary
benefits renewal action to brokers and clients.
Develop an understanding of PCMI system tools including
PERC/WERC/Healthview/BusinessEdge/Deerwalk and HCPS operating systems.
Keep current on new laws and regulations that impact the medical insurance industry (continuing
education/seminars).
Upselling and