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Job Posting Title

Clinical Program Management Director - Remote

Job Description

The Clinical Program Management Director is responsible for the overall coordination and leadership of clinical pharmacy programs for their Blue Cross and Blue Shield (BCBS) clients and serves as the primary clinical relationship manager. This role’s responsibilities may include the management of drug formulary, Utilization Management (UM) programs, benefit design strategies, and other drug therapy related products and services offered by Prime. As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and builds strong relationships with key clinical stakeholders through effective consultative services.

Responsibilities

Coordinate and lead the development, maintenance, and implementation of client specific clinical pharmacy programs in tandem with key internal business partners; programs may include clinical portions of internal and external client planning documents and/or UM program implementations and formulary management (planning PT agenda and client recommendations, maintenance of formulary information in provider and member materials/communications, distribution of formulary publications/communications)

Establish a relationship with the client’s clinical stakeholders through representation of Prime on the client’s internal committees addressing drug therapy, medical, and clinical pharmacy benefit management related issues

Coordinate efforts with Prime’s Pharmaceutical Trade Relations team when developing programs and relationships with pharmaceutical companies

May provide work direction to a Clinical Program Manager or Clinical Program Specialist

Provide consultation and recommendations to the client regarding Prime standard clinical program opportunities, formulary recommendations, benefit design recommendations, and other research applications and opportunities beneficial or of interest to the plan

Provide clinical guidance and support for client’s Health Insurance Marketplace business

Manage incoming requests for information from the plan regarding drug therapy, formulary and clinical program related issues and partner with reporting and analytics team to present meaningful information back to the client

Present Prime’s products, services and recommendations to internal and external stakeholders and work in cooperation with Prime’s operational teams to coordinate and lead client specific custom clinical pharmacy programs

Other duties as assigned

Minimum Qualifications

PharmD or Bachelor of Science Pharmacy degree

Current pharmacist license in good standing with State Board of Pharmacy

7 years of related work, educational, and/or resident experience to include at least 5 years of experience in managed care or clinical pharmacy

Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

Ability to establish rapport and build relationships at all levels within an organization

Expert negotiation and influencing skills

Exceptional written and verbal communication skills

Works effectively across functions, disciplines and/or other groups

Ability to anticipate needs and plan work independently

Demonstrated ability to problem solve through complex situations

Preferred Qualifications

PBM Experience

1 year of management/people leadership experience

Minimum Physical Job Requirements

Ability to travel up to 20% of the time

Constantly required to sit, use hands to handle or feel, talk and hear

Frequently required to reach with hands and arms

Occasionally required to stand, walk and stoop, kneel, and crouch

Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

Reports to Sr Director or VP in the Clinical Program Management departmentPotential pay for this position ranges from $125,200.00 - $200,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

Positions will be posted for a minimum of five consecutive workdays.