Director Clinical Operations - PBM

Overview

This position is responsible for all clinical activities, programs and people at ClearScript. Provide leadership of the Clinical Services Team includes Clinical Account Executives, Clinical Program Managers and Clinical Analysts. Management responsibilities include creating the clinical vision and direction in analysis, research & development, administration and maintenance of clinical programs and formularies managed by ClearScript. This position is also responsible for providing leadership and direction to the client-facing Clinical Account Executives and consistently meeting customer expectations related to service, clinical effectiveness and patient safety; development and implementation of quality measurement and improvement programs, regulatory compliance, program implementation, and effective financial management related to productivity and budgeting in the clinical space. This position serves as the clinical resource and participates in strategic discussions surrounding ClearScript overall business direction as well as potential clients, payer strategies and contracting strategies

Responsibilities Job Description

Provide overall leadership, development and day to day direction to the Clinical Services Teams:

• People management and direction of formulary operations, utilization management, clinical review processes, product pipeline assessments and product development, and other areas as developed or designated
• People management and direction of clinical account services provided to clients, consistently meeting customer expectations related to service, clinical effectiveness and patient safety, and other areas as developed or designated.
• Provide leadership in the clinical development and implementation of quality measurement and improvement programs and regulatory compliance.
• Provide cross functional leadership and support in effective financial management related to productivity and budgeting in the clinical space.
• Serve as a department resource for escalated client or internal issues pertaining to clinical operations.
• Develops and maintains high-level relationships with vendor’s clinical pharmacy team and facilitates executive level discussions to address ClearScript’s clinical pharmacy needs.
• Responsible for understanding and application of all clinical programs currently available from our vendor, including DUR, protocols, prior authorization, etc.
• Responsible for working with our vendor to direct and coordinate provision of clinical programs and communications to ClearScript clients.
  
  
  

Qualifications

Required

Education

• Bachelor of Science/ Doctor of Pharmacy Degree
  
  
  

Experience

• Five to ten years of pharmacy experience, with 3-5 years of managed care experience.
• Three to five years’ experience in clinical pharmacy practice in a managed care setting, including the areas of formulary management and clinical program development and sales.
• Experience selling PBM clinical programs to health plans, consultants, brokers, TPAs and plan sponsors.
• Experience analyzing complex sales situations and developing creative and successful solutions.
• 2 years PBM experience managing clinical processes or people
  
  
  

License/Certification/Registration

• Pharmacy license in good standing
  
  
  

Preferred

Education

• Advanced degree and or pharmacy residency preferred
  
  
  

Experience

• Advanced consultative selling skills with proven track record of successfully constructing solutions for a multifaceted, broad range of complex issues.
• Demonstrated success and resolution-focused interactions with Sales, Account Management, Finance and Product Management teams.
• Proven track record of clinical program sales success at the executive level.
  
  
  

EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status