Job Description

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
Clinical Program Manager Remote

The Clinical Program Manager is responsible for the management of all client specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, and other drug therapy related products and services offered by Prime. As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and builds strong relationships with key clinical stakeholders through effective consultative services.
Responsibilities

• Coordinate formulary management for the client including, client specific Pharmacy &Therapeutics (P&T) or business committee decision making and implementation, oversight of formulary publications, oversight of formulary information in all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies
• Provide consultation and recommendations to the client regarding Prime standard clinical program opportunities, formulary recommendations, benefit design recommendations, and other research applications and opportunities beneficial or of interest to the plan
• Provide clinical guidance and support for client’s Health Insurance Marketplace business
• Manage incoming requests for information from the plan regarding drug therapy, formulary and clinical program related issues and partner with reporting and analytics team to present meaningful information back to the client
• Present Prime’s products, services and recommendations to internal and external stakeholders and work in cooperation with Prime’s operational teams to coordinate and lead client specific custom clinical pharmacy programs
• Other duties as assigned

Minimum Qualifications

• PharmD or Bachelor of Science Pharmacy degree
• Current pharmacist license in good standing with State Board of Pharmacy in the State where the position is located
• 3 years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at least 2 years of work experience in a clinical and/or managed care setting
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Strong verbal and written communication
• Ability to think strategically and demonstrate strong problem solving skills
• Ability to balance and prioritize multiple responsibilities and deliverables
• Experienced and effective working in teams

Preferred Qualifications

• Current pharmacist license in good standing with the Board of Pharmacy
• PBM Experience
• 1 year of direct client management experience
• 1 year of clinical account management experience
• Knowledge of the applicable line of business (e.g., Medicare, Medicaid, Exchange, Commercial, Employer Group)

Minimum Physical Job Requirements

• Ability to travel up to 20% of the time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Sr Director in the Clinical Program Management department

Potential pay for this position ranges from $120,300.00 - $192,300.00 based on location, experience and skills.


















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Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.