Job Description
Clinical Program Manager Remote
locations
Home
time type
Full time
job requisition id
R-10522
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Clinical Program Manager Remote
Job Description
The Clinical Program Manager is responsible for the management of all client specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, 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 formulary management for the client including, client specific Pharmacy &Therapeutics (P&T) or business committee decision making and implementation, oversight of formulary publications, oversight of formulary information in all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies
- 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
- 2 years experience in managed care or clinical pharmacy or completed a Residency Program or the equivalent combination of education and/or relevant work experience
Additional Qualifications
- Strong verbal and written communication
- Ability to think strategically and demonstrate strong problem solving skills
- Ability to balance and prioritize multiple responsibilities and deliverables
- Experienced and effective working in teams
Preferred Qualifications
- Current pharmacist license in good standing with the Board of Pharmacy
- Medicare experience
- 1 year of direct client management
- 1 year of clinical account management
- Knowledge of the applicable line of business (e.g., Medicare, Medicaid, Exchange, Commercial, Employer Group)
- PBM Experience
Minimum Physical Job Requirements
- Depending on primary work location, this position may require travel up to 20%