Clinical Account Executive

Job Description:

• Support pharmacy benefit management programs by developing highly managed clinical strategies, including formulary development, utilization management, rules development, vendor management, and Liviniti’s Clinical Care Management product
• Develop new clinical strategies and oversee clinical programs developed internally and by third parties
• Analyze, interpret, and develop written recommendations using prescription claims data
• Participate in client implementation meetings
• Develop and maintain client relationships to ensure needs are met and satisfaction is maintained
• Collaborate with Account Management to support client needs
• Develop client-specific clinical recommendations to improve healthcare outcomes and control drug spend
• Investigate and resolve client issues
• Make proactive recommendations regarding drug pipeline activity
• Meet with clients to discuss clinical trends, review pharmacy data, and provide recommendations and rationale for clinical management strategies
• Provide drug information as the clinical consultant/expert on the account team
• Provide operational subject matter expertise to Account Management and Implementation teams for clinically related programs
• Analyze and evaluate pharmacy data and reporting, and create/design ad-hoc reports
• Develop communication materials regarding formulary and utilization management changes, health literacy, medication adherence, and pharmacy trends
• Support customer service when clinical claim review is needed
• Collaborate with cross-functional teams to build consensus and support organizational goals
• Abide by HIPAA obligations related to Protected Health Information (PHI), report discovered violations, and complete required HIPAA training
• Perform other responsibilities and projects as needed

Requirements:

• PharmD from an accredited College of Pharmacy; B.S. Pharmacy accepted
• Five (5) years of pharmacy experience working for a Health Plan or PBM
• Experience in client-facing role and client presentations
• Experience with utilization management including specialty medication management strategies, clinical program development, drug use evaluation, and formulary development and maintenance
• Excellent written and oral skills, both in developing materials and presenting to clients
• Ability to multi-task and work outside the clinical environment
• Exceptional clinical, business, and relationship building skills
• Ability to work independently
• Ability to translate clinical information into a manner appropriate for clinical and non-clinical audiences
• Ability to research and analyze medical literature, including drug information, disease states, and clinical practice guidelines, and apply sound clinical judgment
• Support the Clinical, Account Management, and Implementation teams
• Maintain professional image and presence
• Adhere to all SS policies and procedures
• Completion of a pharmacy practice, managed care, or specialty residency (preferred)
• Three (3) years of experience in analyzing raw prescription claims data (preferred)
• Proficiency in using database information systems and Microsoft Office Suite (preferred)
• Ability to work during core hours of 8:00AM to 5:00PM CT and adjust work times to cover meetings in all time zones
• Ability to work extended hours, weekends and holidays pursuant with industry demands
• Up to 10% - 25% travel, including travel outside the local area and overnight

Benefits:

• Medical, Dental, Vision insurance
• Disability and Life insurance
• Employee Assistance Program
• Remote work options
• Generous Paid-Time Off
• Annual Reviews and Development Plans
• Retirement Plan with company match; immediately 100% vested