Clinical Program Manager

Exemption Status:

“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!

Job Description

Summary:  The Clinical Program Manager (CPM) will be a Mississippi based and licensed pharmacist with a minimum of 5+ years’ practicing pharmacy and Medicaid management. The 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. 

Education and/or Experience  

Doctor of Pharmacy (or equivalent combination of education and experience).  Must have 5+ years’ related experience.  Medicaid experience preferred.

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.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

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.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

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.

Disclaimer:

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.