Clinical Program Manager

Prime Therapeutics   •  

Omaha, NE

Industry: Business Services

  •  

8 - 10 years

Posted 363 days ago

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 otherdrug 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 withreporting 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 
  • 10 years of related work, educational, and/or resident experience to include at least 2years of experience in managed care or clinical pharmacy

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
  • PBM Experience
  •  1year of direct client management experience
  • 1year of clinical account management experience
  • Knowledge of the applicable line of business (e.g., Medicare, Medicaid, Exchange, Commercial, Employer Group)

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 Principal, Sr Principal, or VP in the Clinical Program Management department

R-01817