“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
Summary: The Clinical Program Manager (CPM) will have a solid working knowledge of Medicaid program pharmacy coverage and payment rules and possess relevant experience in managing accounts and clinical
projects. This pharmacist will attend onsite meetings at the state office building upon Client’s request and maintain responsibility for managing all aspects of the preferred drug list and supplemental rebate administration.
In addition to account/contract management responsibilities, this position also works to optimize the clinical quality and cost-effectiveness of drug therapy for a state Medicaid agency and their members. The focus is on
rational management of drug utilization by employing analytical tools and an evidence-based approach to achieve lower net cost, better health outcomes, and high levels of satisfaction for plan sponsors and their members. The position works within corporate resources to achieve overall account and company financial goals. Relies on data and performance indicators, as well as experience and judgment, to identify and promote performance improvement opportunities which attain the aligned goals of MedImpact and the client.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Oversight of all contract requirements, including but not limited to all services, deliverables, and oversight
of both internal and subcontractor operations. This includes oversight of preferred drug list (PDL)
development, maintenance and drug manufacturer invoicing team and rate-setting team.
Serve as main point of contact for the account. Works with and oversees a diverse set of professional
staff to fulfill contract requirements, including oversight of any subcontracts and their performance.
Provides recommendations to assigned clients that align with the clients’ goals of lower net costs and
high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List
(PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria
development, P&T support and participation, recommendations for rational drug PDL positioning, on-line
system edits and restrictions, on-going clinical product evaluations, and recommendations regarding
client pharmacy benefit utilization and performance trends.
Provides clinical and Medicaid consultative services in accordance with contracted clinical and
consultative services. Acts as an integral part of designing, developing, and driving the clinical
components of assigned account team’s strategic and financial goals. The CPM’s focus will be centered
on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously
improve the plan sponsor’s quality-focused and financial performance metrics.
Identifies and promotes MedImpact’s evidence-based interventions and communication programs to
clients. Provides documentation of recommendations for clinically appropriate and financially beneficial
clinical initiatives (e.g. rebate enhancement, lower net cost, generic programs, QA programs).
Recommends clinically appropriate PDL changes by while considering the lowest net cost after rebates,
market shifts and utilization.
Coordinates clinical utilization analyses and presentations to clients. Ensures timely and accurate review
of plan data, according to policy, with appropriate intervention recommendations.
Coordinates clinical support of Preferred Drug Lists during plan sponsor’s implementation.
Participates in quarterly state P&T meetings as per client contract.
Supervisory Responsibilities
This job has no supervisory responsibilities.
Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and
interpersonal communication skills (listening/verbal/written). One must be able to; Respond promptly to client
needs; solicit client feedback to improve service; Respond to requests for service and assistance from clients;
Meet commitments to clients; Manage difficult or emotional client situations. Experience managing or
participating in large projects is highly preferred.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Doctor of Pharmacy (or equivalent combination of education and experience). Must have 5+ years’ related
experience. Medicaid experience preferred.
Computer Skills
To perform this job successfully, an individual should have knowledge of Microsoft Office Suite and a working
knowledge of relational databases.
Certificates, Licenses, Registrations
Registered Pharmacist in the State of Mississippi. If licensure is in an equivalent state, must have the ability to
obtain a MS license within 6 months of the start of employment.
Other Skills and Abilities
Account management or comparable experience (required)
Analytical skills with Health Informatics experience (preferred).
Experience in promoting drug cost management programs (preferred).
To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
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