Vice President, Clinical Pharmacy – PBM

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ProCare Rx

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

ProCare Rx is a pharmacy benefit manager (PBM) that delivers comprehensive pharmacy benefit management solutions focused on transparency, flexibility, and clinical excellence. The company provides claims adjudication, clinical services, rebate management, cost-containment programs, and specialized offerings such as GLP-1 and hospice medication management through a high-performance, web-enabled claims processing platform and U. S. -based support. ProCare Rx serves institutional and enterprise clients with claim-level analytics, 24/7 customer service, and scalable transaction processing.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• Professional development and knowledge sharing opportunities • Mentorship and support for clinical staff • Willingness to travel as needed • Equal Opportunity Employer