Director, Specialty Clinical Solutions

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $143k - $243k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

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Prime Therapeutics

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1998

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Prime Therapeutics is a trusted pharmacy solutions provider dedicated to transforming health care through innovation and transparency. The company offers a wide range of services including clinical solutions for improved member outcomes, drug access and affordability, specialty drug management, and condition management for chronic health issues. With over 7,000 employees, Prime Therapeutics aims to challenge norms in the pharmacy industry, providing exceptional experiences and simplifying the complex for millions across the nation. Their mission goes beyond profit, focusing on creating transformative impacts with long-term solutions, utilizing modern technology and holistic approaches in specialty pharmacy management. Owned by mission-driven partners, Prime Therapeutics emphasizes true transparency and conflict-free service, fostering a culture of care and shared purpose in health care.

📋 Description

• Oversee clinical services and strategies within Medical Pharmacy and Specialty programs • Serve as lead clinical consultant and subject matter expert for assigned clients • Provide strategic guidance on medical pharmacy and specialty programs • Partner with account management and business development teams on client retention, growth opportunities, financial analyses, and new business initiatives • Develop innovative medical pharmacy strategies using data-driven insights, clinical solution design, and program enhancements • Evaluate emerging therapies, market trends, and medical benefit drug management opportunities • Oversee client-facing medical pharmacy programs and utilization management solutions, including fee schedule management, prior authorization, and post-service claim edits • Identify opportunities to expand existing programs and recommend new solutions • Collaborate with cross-functional teams to evaluate program performance, develop business rules, deliver actionable insights, and drive continuous improvement • Lead development of client-facing clinical materials, strategic presentations, thought leadership content, and industry publications • Represent the organization as a clinical expert and mentor through industry engagement, enterprise initiatives, conference presentations, and guidance to peers and cross-functional partners • Perform other duties as assigned

🎯 Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree • 7 years of work experience in medical pharmacy or at a health plan with multiple lines of business • Current pharmacist license to practice in the applicable state(s) • Must be eligible to work in the United States without the need for work visa or residency sponsorship • Strong interpersonal, communication, consultation, organizational, tracking, and follow-up skills • Ability to research, obtain, coordinate, and integrate feedback from diverse operational groups • Excellent verbal and written communication skills • Strong presentation skills • Preferred: Medical Pharmacy management, strategy, and data interpretation experience at a health plan • Preferred: Health plan experience managing drugs on both the Pharmacy and Medical benefit across all lines of business • Ability to comply with security responsibilities, legal, regulatory, contractual, and internal policy requirements • Ability to perform the essential functions of the job, with reasonable accommodations where applicable

🏖️ Benefits

• Benefits, incentives, and additional compensation are available through the employer’s Benefits Page • Reasonable accommodations for employees with disabilities • Equal opportunity and affirmative action employment • Tobacco-Free Workplace