Clinical Account Executive
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Job Description
Clinical Account Executive developing formulary, utilization management, and care-management strategies for Liviniti’s pharmacy benefit management clients. Advising clients through claims analysis, clinical recommendations, and drug-trend expertise.
Responsibilities:
- Support pharmacy benefit management programs by developing highly managed clinical strategies, including formulary development, utilization management, rules development, vendor management, and Liviniti’s Clinical Care Management product
- Develop new clinical strategies and oversee clinical programs developed internally and by third parties
- Analyze, interpret, and develop written recommendations using prescription claims data
- Participate in client implementation meetings
- Develop and maintain client relationships to ensure needs are met and satisfaction is maintained
- Collaborate with Account Management to support client needs
- Develop client-specific clinical recommendations to improve healthcare outcomes and control drug spend
- Investigate and resolve client issues
- Make proactive recommendations regarding drug pipeline activity
- Meet with clients to discuss clinical trends, review pharmacy data, and provide recommendations and rationale for clinical management strategies
- Provide drug information as the clinical consultant/expert on the account team
- Provide operational subject matter expertise to Account Management and Implementation teams for clinically related programs
- Analyze and evaluate pharmacy data and reporting, and create/design ad-hoc reports
- Develop communication materials regarding formulary and utilization management changes, health literacy, medication adherence, and pharmacy trends
- Support customer service when clinical claim review is needed
- Collaborate with cross-functional teams to build consensus and support organizational goals
- Abide by HIPAA obligations related to Protected Health Information (PHI), report discovered violations, and complete required HIPAA training
- Perform other responsibilities and projects as needed
Requirements:
- PharmD from an accredited College of Pharmacy; B.S. Pharmacy accepted
- Five (5) years of pharmacy experience working for a Health Plan or PBM
- Experience in client-facing role and client presentations
- Experience with utilization management including specialty medication management strategies, clinical program development, drug use evaluation, and formulary development and maintenance
- Excellent written and oral skills, both in developing materials and presenting to clients
- Ability to multi-task and work outside the clinical environment
- Exceptional clinical, business, and relationship building skills
- Ability to work independently
- Ability to translate clinical information into a manner appropriate for clinical and non-clinical audiences
- Ability to research and analyze medical literature, including drug information, disease states, and clinical practice guidelines, and apply sound clinical judgment
- Support the Clinical, Account Management, and Implementation teams
- Maintain professional image and presence
- Adhere to all SS policies and procedures
- Completion of a pharmacy practice, managed care, or specialty residency (preferred)
- Three (3) years of experience in analyzing raw prescription claims data (preferred)
- Proficiency in using database information systems and Microsoft Office Suite (preferred)
- Ability to work during core hours of 8:00AM to 5:00PM CT and adjust work times to cover meetings in all time zones
- Ability to work extended hours, weekends and holidays pursuant with industry demands
- Up to 10% - 25% travel, including travel outside the local area and overnight
Benefits:
- Medical, Dental, Vision insurance
- Disability and Life insurance
- Employee Assistance Program
- Remote work options
- Generous Paid-Time Off
- Annual Reviews and Development Plans
- Retirement Plan with company match; immediately 100% vested
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