Note: The job is a remote job and is open to candidates in USA. AcariaHealth, part of Centene, provides healthcare and pharmacy services that support more accessible and effective medication care. The Clinical Account Manager provides clinical expertise to clients, develops and evaluates benefit and clinical programs, analyzes drug utilization data, and collaborates with internal teams to optimize therapeutic outcomes and cost-effective medication benefits.
Responsibilities
- Provide expertise in benefit design planning methods and strategies
- Provide clinical expertise to clients, explain clinical programs, and communicate new practice or clinical information to clients
- Develop and present performance reviews in conjunction with client account team
- Perform clinical data and drug utilization review analysis to meet client requirements and requests
- Collaborate with Clinical Pharmacists to enhance drug utilization review program and prior authorization review process and assist with related activities
- Provide input into the Request for Proposal process and work with Marketing and Sales to facilitate timely response and data analysis
- Ensure that client clinical needs are met, including formulary management, benefit design, drug utilization review and clinical programs
- Participate in the development and management of customized clinical business plans appropriate for each client, including the evaluation of current client program and restrictions (prior authorization, quantity limits, age limits) to determine appropriate utilization of drug therapy
- Consult with clients to develop and implement appropriate clinical interventions and claim adjudication edits
- Participate in the development of disease state management modules by interfacing with company partners to improve array of marketable products
- Performs other duties as assigned
- Complies with all policies and standards
Skills
- This is a remote position, with some travel required approximately 3-4 times per year
- Bachelor's degree and licensed qualification in pharmacy (PharmD., RPh)
- Current state's pharmacy license with no restrictions
- 3+ years of experience in Clinical pharmacy operations or case management experience in specialty pharmacy preferred
- Direct experience interfacing with payers and/or manufacturers preferred
Benefits
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- A flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives, subject to applicable compensation practices and program eligibility
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