Plays a key role in various clinical pharmacy accounts: overseeing the overall clinical activities for various clients and up selling additional clinical services and ensuring renewal of the account. Responsible for working with Account Managers in identifying common customer problems that require clinical solutions, and facilitating the implementation and monitoring of clinical solutions in support of our clients goals to reduce expenses and improve care.
Serves as facilitator and mentor to the clinical liaisons for assigned contract(s). Assists Account Managers with managing overall client relationship and driving the adoption of recommended clinical solutions as well as assisting Account Managers in managing the P&L of the account in order to meet targeted profitability. Understands that the financial impact of all clinical recommendations is essential for both the client's cost of care and the overall administration of the programs. Activities address impact on customers, operations, program integrity, pricing, quality and satisfaction. Develops and tracks appropriate metrics that monitor the quality and care cost impact of the clients program.
Provides guidance, assistance and mentoring to assist the Account Manager staff in attaining goals. Requires communication across all departments and an understanding of the strategic impact of the programs to customers and clients and extensive knowledge of how the programs integrate with other clinical initiatives. As a collaborative partner with our customers, must have expertise with data management and overall healthcare trends specific to the Medicaid population.
Act as primary point of contact with the State, MCOs, and other Stakeholders. Responsible for all Vendor requirements under the SOW and Contract.
Oversee Vendor business processes and documentation.
Interact, communicate, and coordinate to ensure continuity of pharmacy unit activities and responsibilities.
Accountable for development, coordination, and publication of communication with outside entities, e.g., written provider communications, pharmacy- related web content, etc.
Coordinate and communicate with provider associations, and other outside entities, including the general public.
Initiate and manage system change requests and documentation.
Accountable for appropriate representation at pharmacy- related Boards and Committees (e.g., Nevada Board of Pharmacy, DUR Board, Silver State Scripts Board, Medical Care Advisory Committee, etc.)
Acquire, analyze, and maintain information regarding pharmacy benefit management "best practices".
Responsible for reviewing and approving all reports that are the responsibility of the Vendor.
Other Job Requirements
8+ years of pharmacy experience.
5+ years of experience in Pharmacy Benefits Management (PBM), Health plan or Medicaid clinical customer service.
Working knowledge of MS Office Suite and COGNOS or comparable.
Proven ability to plan, organize, schedule, direct, control and monitor project activities.
Project management experience and knowledge of health plans, PBMs or Medicaid required.
General Job Information
Account Pharmacy Services Director - REMOTE Nevada
Bachelors: Pharmacy (Required), PharmD: Pharmacy
License and Certifications - Required
RPH - Registered Pharmacist - Pharmacy
License and Certifications - Preferred
PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy