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 Development Director, Stars - Remote
Job Description
The Clinical Program Development Director contributes to the development of drug management strategy for the designated clinical product domain (i.e. Utilization Management, Formulary, Concurrent and Retrospective Drug Utilization Review (DUR), Drug list management). This position leads a cross-functional team through the execution of objectives within their clinical product domain and may align activities around a specific line of business (MedD, Medicaid, Health Insurance Marketplace, Commercial).
Responsibilities
- Serve as a subject matter expert within the designated clinical product domain to drive departmental strategy and new clinical product offerings (i.e. project representation across business units)
- Represent the domain in partnership with key internal stakeholders to support client communications
- Manage essential business processes and allocate resources to support the development and operations of designated clinical product domain
- Monitor the performance of clinical products and implement continuous quality improvement plans to ensure the outcome improves cost and quality of care and assures regulatory compliance
- Manage the implementation of new clinical programs and clients within designated clinical product domain; may oversee clinical product management processes to ensure compliance with client delegation or service agreements specific to clinical products
- Manage essential business processes to ensure compliance with accreditation standards (NCQA, URAC) and federal and state regulations that relate to clinical products
- Other duties as assigned
Minimum Qualifications
- Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
- Current pharmacist license in good standing with the State Board of Pharmacy in the State where the position is located
- 7 years of related work and/or educational experience to include:
- 5 years of related clinical experience
- 2 years of managed care experience
- Must be eligible to work in the United States without need for work visa or residency sponsorship
Additional Qualifications
- Effective written and verbal communication skills
- Ability to collaborate effectively across departments and at all levels within an organization
- Ability to think critically and anticipate the broad impact of decisions
- Demonstrated ability to manage projects from ideation to completion
Preferred Qualifications
- 1 year of experience in the development of drug management strategy and managing clinical product functions
- 1 year or management/people leadership experience
- Experience working within a matrix environment
- Previous PBM experience
Minimum Physical Job Requirements
- Ability to travel up to 10% 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
- Reports to Sr Director or AVP in the Clinical Program Development department
Potential pay for this position ranges from $125,200.00 - $200,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our
Benefits Page and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
