Senior Pharmacist Account Manager - Remote in Raleigh NC

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Senior Pharmacist Account Manager - Remote in Raleigh, NC

Summary

Leads the clinical support for various multi-functional projects critical to the company in achieving its clinical and operational goals and objectives. Primary lead for delivering proactive, clinical, consultative solutions to clients. Serves as clinical liaison for assigned Pharmacy contract(s) and manages overall client relationship. Participates in the development of clinical management products and services. Activities address impact on customers, operations, program integrity, pricing, quality, satisfaction, and outcomes. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of client programs. Requires coordination and communication across all departments, an understanding of the strategic impact of the program(s) for the company, knowledge of how to integrate with other clinical initiatives, and familiarity with data management and analysis.

Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancements). Identifies opportunities for additional services that address unmet customer needs. Initiates the development of new and innovative clinical programs to meet client's needs based on evaluation of their pharmacy and medical claims data. Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and programs and provides support to client-specific Pharmacy and Therapeutics functions, DUR committees and responsibilities. Supports elevated customer service and prior authorization inquiries specific to assigned accounts.

Directly responsible for managing strategic accounts across various lines of business (Managed Medicaid; Commercial; Medicare; Exchange) under the guidance of the Vice President of Clinical Account Management.

• Initiates and leads the development of clinical program enhancements, trend monitoring and management strategies, and better practices for assigned clients. Assists with development, enhancement, and maintenance of operational functions, policy and clinical support and provider education. Serves as a subject matter expert.

• Develops, implements, and monitors project plan requirements and timelines, ensures all necessary support, tools and technology are available, and follows up as needed. Meets with business process owners and other appropriate personnel to identify project goals, objectives, critical success factors, and success measures. Works closely with teams to ensure Oversees and owns consistent delivery of approved programs to their client. Ensures operations are standardized at the fullest extent possible. Provides overall project coordination for the client's clinical and operational functions.

• Oversees and coordinates implementation of new clinical programs and serves as clinical liaison between the company and customers as needed.

• Assists in modifying implementation approaches within budget and operational framework.

• Revenue Generation - Works jointly with Account Management team to ensure revenue goals, administrative expenses are managed.

• Develops strong relationships with key contacts at client level.

• Develops strong relationships and contacts within the company that are supportive of the achievement of increased revenue goals and improved outcomes and quality of care.

• Supports other functions as requested throughout the program development and client management lifecycle including finance, outcomes, communications and IT.

• Communicates frequently, either by phone or in person, with client to report program progress. Establishes priorities and maintains positive client relationship. Responds to clients requests for information. Delivers regular account Quarterly Business Reviews (QBRs) to clients.

• Proactively assesses, investigates and resolves difficult issues to achieve customer satisfaction.

• Proactively delivers consultative clinical solutions to clients to address their complex pharmacy and medical management challenges.

• Maintains client Preferred Drug Lists and custom formularies.

• Responsible for oversight of all program reporting. Ensures standard and ad hoc reports are provided accurately and on time.

• Supports the State Drug Utilization Review Boards and Pharmacy and Therapeutics (P&T) Committees.

• Develops and maintains client specific prior authorization criteria as part of the Pharmacy and Therapeutics process.

• For custom clients manages the custom pharmacy and therapeutics process.

• Manages weekly custom client drug updates in RxFlex.

• Manages drug evaluation process and from drug to coding and ensures drugs are appropriately evaluated.

• Works as liaison between the client and the rebate team in presenting and evaluating rebate opportunities

• Presents the rebate opportunities to clients and follows decision through to implementation

Responsibilities

• Provider experience preferred.

• Marketing - 5+ years

• Managed Care Pharmacy Experience - 5+ years.

• Pharmacist Account Management Experience - 5+ years.

• Project/Program Management- 5+ years

• Able to perform basic financial analysis.

• Proven ability to plan, organize, schedule, direct, control and monitor project activities.

• 5+ years' experience in clinical operations, quality, network, pharmacy or project management.

• Project management experience and knowledge of health plans required.

• Well-developed interpersonal skills.

Work Experience

Work Experience - Required:

Account Management, Managed Healthcare, Project/Program Management

Work Experience - Preferred:

Marketing

Education

Education - Required:

Bachelors - Pharmacy

Education - Preferred:

PharmD - Pharmacy

Certifications

Certifications - Required:

RPH - Registered Pharmacist - Pharmacy - Pharmacy

Certifications - Preferred:

PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy - Pharmacy

Potential pay for this position ranges from $109,480.00 - $186,120.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (***/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employerand a Tobacco-free workplace. We encourage diverse candidates to apply and all qualified appli.