Specialty Clinical Program Director

Business Services

Salary depends on experience
Posted on 08/15/17
Bloomington, MN
Business Services
Salary depends on experience
Posted on 08/15/17

Specialty Clinical Program Director

Job Description

Purpose

The Specialty Clinical Program Director uses clinical expertise to direct the overall clinical strategy, portfolio of clinical solutions, outcomes and tracking for specified therapeutic categories.  This includes trend management, key capabilities, specialty programs including Best in Care guarantees and programs implemented at dispensing pharmacies. This position will establish and maintain cross functional partnerships with clinical and non-clinical capability owners to drive successful execution of specialty programs.  This position will be the subject matter expert for specific therapeutic categories for both internal and external stakeholders, including a deep knowledge competitor programs.  This role will also support the Specialty Regional Consulting Directors in presenting program results and solutions to Clients.

Responsibilities

  • Develop clinical solutions for specific therapeutic categories; Oversee the development and implementation of product solutions
  •  Maintain knowledge of industry trends
  • Provide insight into competitor products and services
  • Partner with the following stakeholders for:
    • Health Outcomes and Analytics teams: to manage/ monitor data in areas such as: trend/net trend, net ingredient cost, utilization % change, brand inflation, specialty network savings, formulary compliance, rebate/Rx, specialty network savings, UM savings for pharmacy and medical benefits, Reimbursement solutions, Site of Care, Coupons, 340b
    • Joint Venture: oversight for all clinical programs included within the scope of the contract, including program development, maintenance, and reporting
    • Pharmacy Relations Trade: for collaboration on new programs that may impact manufacturer contracting, manufacturer contract performance and other areas as needed
    • Pharmacy team: to serve as strategy partner for UM programs, medical policy, formulary, pipeline, P&T committee recommendations, maintenance of drug lists, etc.
  • Strategize with Networks to develop and assist with management of therapeutic category performance and reporting, including both the Joint Venture and the Prime specialty networks
  • Provide support to Specialty program and product team in development and maintenance of any additional specialty solutions
  • Other duties as assigned

Minimum Qualifications

  •  Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree and current pharmacist license in good standing with the State Board of Pharmacy in the state where the position is located

OR

  • Registered Nurse (RN) licensed in the state where the position is located
  • 10 years of work experience in health care, including 5 years pharmacy or nursing experience in managed care or specialty pharmacy

Additional Qualifications

  • Ability to facilitate change

Preferred Qualifications

  • PBM experience
  • Advanced degree or Certification in specific therapeutic category

Minimum Physical Job Requirements

  • 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 AVP in the Specialty and Clinical Consulting Services function

R-00825

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