Plays a key role in various multi-functional projects critical to the company in achieving its clinical and operational goals and objectives. Develops, implements and monitors clinical specialty programs in the field. Serves as clinical liaison for assigned Pharmacy contract(s). Manages overall client relationship. Participates in the development of clinical management products and services. Activities address impact on customers, operations, program integrity, pricing, quality and satisfaction. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of the client's program. Requires communication across all departments, an understanding of the strategic impact of the program(s) for the company, knowledge of how the specialty programs integrate with other clinical initiatives, and expertise with data management.
Leads the development of clinical program enhancements and better practices.
Assists with development, enhancement, and maintenance of operational functions, policy and clinical support and provider education.
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 the project's goals, objectives, critical success factors, and success measures.
Works closely with teams to ensure consistent delivery of approved programs to their client.
Ensures operations are standardized at the fullest extent possible.
Provides overall project coordination for the contract's clinical and operational functions.
Oversees and coordinates implementation of new specialty programs and serves as liaison between the company and customers as needed.
Assists in modifying implementation approaches within budget and operational framework.
Revenue Generation - Works jointly with Account Manager 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.
Supports other functions as requested throughout the program development 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 client's requests for information.
Assesses, investigates and resolves difficult issues to achieve customer satisfaction.
Maintains contract's Preferred Drug List.
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) Committee.
Other Job Requirements
Responsibilities
3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency.Proven ability to plan, organize, schedule, direct, control and monitor project activities. Well-developed interpersonal skills. Able to perform basic financial analysis.Project management experience and knowledge of health plans required.
General Job Information
Title
PBM Clinical Account Manager - REMOTE Nevada
Grade
29
Work Experience - Required
Marketing, Pharmacy, Project/Program Management
Work Experience - Preferred
Education - Required
Bachelors - Pharmacy
Education - Preferred
PharmD - Pharmacy
License and Certifications - Required
RPH - Registered Pharmacist - Pharmacy
License and Certifications - Preferred
PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
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