
201 - 500 employés
🏥 Santé
⚕️ Assurance santé
💊 Pharmaceutique
Healthcare • Healthcare Insurance • Pharmaceuticals
ProCare Rx est un gestionnaire de prestations pharmaceutiques (PBM) qui offre des solutions complètes de gestion de prestations pharmaceutiques axées sur la transparence, la flexibilité et l'excellence clinique. L'entreprise propose une adjudication des réclamations, des services cliniques, une gestion des remises, des programmes de maîtrise des coûts, et des offres spécialisées telles que la gestion des médicaments GLP-1 et des soins palliatifs via une plateforme de traitement des réclamations performante et accessible sur le web avec un support basé aux États-Unis. ProCare Rx sert des clients institutionnels et d'entreprise avec des analyses au niveau des réclamations, un service client 24/7 et un traitement des transactions évolutif.
🕒 il y a 2 jours
🗣️🇺🇸🇬🇧 Anglais requis
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201 - 500 employés
🏥 Santé
⚕️ Assurance santé
💊 Pharmaceutique
Healthcare • Healthcare Insurance • Pharmaceuticals
ProCare Rx est un gestionnaire de prestations pharmaceutiques (PBM) qui offre des solutions complètes de gestion de prestations pharmaceutiques axées sur la transparence, la flexibilité et l'excellence clinique. L'entreprise propose une adjudication des réclamations, des services cliniques, une gestion des remises, des programmes de maîtrise des coûts, et des offres spécialisées telles que la gestion des médicaments GLP-1 et des soins palliatifs via une plateforme de traitement des réclamations performante et accessible sur le web avec un support basé aux États-Unis. ProCare Rx sert des clients institutionnels et d'entreprise avec des analyses au niveau des réclamations, un service client 24/7 et un traitement des transactions évolutif.
• Provide hands-on and client-facing clinical leadership for pharmacy benefit management programs • Oversee PBM clinical areas, including rebate and clinical programs, step therapy, prior authorization, cost containment strategies, and Pharmacy & Therapeutics Committee participation • Manage clinical staff and provide clinical oversight of therapeutic trends, utilization patterns, patient outcomes, and cost-management opportunities • Ensure programs align with evidence-based medicine, FDA guidelines, URAC PBM Standards, and internal performance improvement requirements • Partner with clients to establish clinical goals, deliver recommendations, and present performance reviews • Serve as a subject matter expert for clinical discussions, client strategy sessions, and RFP/finalist activities • Collaborate with client services, sales, and implementation teams on clinical program delivery, client support, and sales presentations • Mentor clinical staff and contribute to professional development and high-quality client deliverables • Monitor emerging therapies, regulatory changes, and PBM trends to inform program design and innovation • Develop or enhance clinical programs and services, including specialty pharmacy and utilization management initiatives • Lead industry thought leadership, publications, media engagements, conferences, and promotion of the organization’s clinical value proposition
• Bachelor’s degree in Pharmacy from an accredited college of pharmacy • Minimum eight years of pharmacy practice experience required, in PBM, managed care, retail, or hospital settings • Focused managed care experience preferred • Experience collaborating with clients and internal teams on clinical program design and delivery • Strong clinical acumen and ability to interpret and communicate healthcare trends • Excellent staff management, communication, presentation, and client relationship skills • Proven time management and organizational skills to manage multiple priorities • Adaptable, collaborative, and solution-oriented • Willingness to travel as needed • Doctor of Pharmacy (PharmD) preferred • MBA or other advanced degree a plus • Knowledge of evidence-based medicine, FDA guidelines, and URAC PBM Standards
• Professional development and knowledge sharing opportunities • Mentorship and support for clinical staff • Willingness to travel as needed • Equal Opportunity Employer
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