Clinical Domain Project Manager – PBM

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🔥 1 minute ago

🌵 Arizona, Massachusetts, +1 more states – Remote

🌵 Arizona – Remote 🍂 Massachusetts – Remote ☕ Washington – Remote

⏳ Contract/Temporary

🟠 Senior

🔴 Lead

🏥 Clinical Operations

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Briljent

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1998

💼 Consulting

🏥 Healthcare

🏛️ Government

Consulting • Healthcare • Government

Briljent is a consulting and professional services firm that helps organizations bridge the gap between strategy and execution by focusing on people and performance. Since 1998, Briljent has delivered training, organizational change management, project and program management (PMO), health strategy and innovation, staffing services, and integrated solutions that combine consulting, project delivery, and workforce augmentation. They work with government (state and federal), healthcare and human services, education, and private sector clients (including Fortune 500 companies) to support technology implementations, compliance initiatives, workforce readiness, and complex transformations. Briljent emphasizes instructional design, certified change practitioners, PMPs, former healthcare policy and Medicaid leaders, and a proven recruiting process to deliver measurable outcomes such as increased adoption, reduced risk, and sustainable organizational change.

📋 Description

• Lead pharmacy clinical projects through initiation, planning, execution, monitoring, and closure • Develop and maintain integrated project plans, schedules, milestones, dependencies, and deliverables • Facilitate requirements gathering, design reviews, solution validation, testing, and implementation activities • Coordinate cross-functional clinical, operational, technical, and business workstreams • Manage project budgets, scope, schedule, risks, issues, assumptions, and dependencies • Support drug coverage administration, Preferred Drug List (PDL) management, prior authorization, electronic prior authorization (ePA), and drug utilization review (DUR) initiatives • Serve as the primary point of contact for client, clinical, and internal project stakeholders • Facilitate decision-making discussions and executive governance meetings • Communicate project status, risks, issues, and mitigation strategies to leadership • Build relationships with pharmacy directors, clinical pharmacists, business analysts, product teams, and external vendors • Ensure compliance with federal and state Medicaid requirements and support audit, regulatory review, and contractual reporting readiness • Coordinate efforts involving CMS, Medicaid agencies, PBMs, healthcare partners, pharmacy system vendors, clinical review organizations, and state stakeholders • Manage integrations, dependencies, issue resolution, and escalations across external partners • Lead implementation readiness reviews and go-live planning • Coordinate training, deployment, cutover, stabilization, continuous improvement, and lessons-learned activities • Develop implementation plans, communication strategies, and transition-to-operations procedures

🎯 Requirements

• Demonstrated success leading large-scale healthcare or pharmacy benefit management (PBM) implementations • Experience managing multiple workstreams and vendors simultaneously • Experience leading end-to-end lifecycle activities from project startup through post go-live support • Experience with Preferred Drug List (PDL) administration • Experience with prior authorization (PA) programs • Experience with electronic prior authorization (ePA) and drug utilization review (DUR) • Experience with clinical policy administration and utilization management initiatives • Expert-level schedule performance management using Microsoft Project • Deliverable management, including Medicaid deliverable oversight • Risks, actions, issues, and decisions (RAID) management • Project controls based on the Project Management Body of Knowledge (PMBOK) • Cross-domain coordination across claims, provider, member, clinical, rebate, and portal functions • Seven or more years of project management experience • Seven or more years of experience supporting Pharmacy Benefit Management (PBM) Medicaid programs • PMP certification preferred, not required • Must be eligible to work in the United States • No sponsorships are available • Must successfully complete a background check prior to onboarding • Ability to occasionally lift up to 20 lbs. • Ability to talk, hear, sit, stand, and use technology tools such as a laptop for extended periods • Close vision and ability to adjust focus

🏖️ Benefits

• Health Care Plan (Medical, Dental & Vision) • Retirement Plan (401k, IRA) • Life Insurance (Basic, Voluntary & AD&D) • Paid Time Off (Vacation, Sick & Public Holidays) • Short Term & Long Term Disability • Work From Home • Wellness Resources