FreshRemote.Work

Clinical Account Manager - Georgia PDL - Remote

Home, United States

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 Account Manager - Georgia PDL - Remote

Job Description

Innovative business clinician accountable for building and maintaining customer relationships as well as leadership of the account teams within all assigned accounts. Charged with delivering results that demonstrate value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract compliance.Accountable for developing and executing the strategic plan for their accounts in conjunction with sales and operations.

Responsibilities

  • Performs customer centric pharmacy services.
  • Owns overall account satisfaction for all assigned accounts.
  • Develops strong relationships with pharmacy department or designated customer contacts.
  • Directs operations account manager in resolving customer service issues and actions supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
  • Maintains knowledge in all aspects of the contracts with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment.
  • Creates and maintains partnerships with customers through the development, implementation and execution of strategic business plans that result in long term retention of profitable relationships.
  • Ensures all Customer and Account-Facing services are provided in a consistent and timely fashion.
  • Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement).
  • Identifies opportunities for additional services that address unmet customer needs.
  • Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and programs and provides support to client-specific Pharmacy and Therapeutics functions, DUR committees and responsibilities.
  • Supports elevated customer service and prior authorization inquiries specific to assigned accounts.
  • Manages financial aspects of account(s).
  • Ensures revenue goals are met, cost of care and administrative expenses managed, and EBIDTA targets achieved for the assigned account(s).
  • Ensures contract performance through risk management activities including such items as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment.
  • Develops opportunities: Seeks and identifies pharmacy products and service requirements based on a thorough understanding of each customer's strategic business goals and the strategic business direction of the product set.
  • Aggressively drives up-sell of pharmacy program solutions through consultative methods and ensures flawless handoff to sales and relationship management for contract execution.
  • Supports sales and account management in renewal activities related to assigned accounts.
  • Manages talent: Accountable for identifying creative talent to serve the account, as well as retention of high performing team members.
  • Ensures staff is trained and receive opportunities to learn new things.

Education & Experience

  • Bachelors - Pharmacy
  • 2+ years of Management Leadership
  • 5+ years of Pharmacy

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

  • 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency.
  • Proven ability to plan, organize, schedule, direct, control and monitor project activities.
  • Well-developed interpersonal skills.
  • Able to perform basic financial analysis.
  • Project management experience and knowledge of health plans required.
  • Provider experience preferred.

Preferred Qualifications

  • Masters’ Degree
  • PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy

Physical Demands

  • Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
  • Must be able to constantly operate a computer and/or other office productivity equipment
  • Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
  • Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.

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, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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.

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Job Profile

Regions

North America

Countries

United States

Restrictions

Fully remote Must be eligible to work in the United States Tobacco-free workplace

Benefits/Perks

Additional compensation Benefits at a glance Fully remote Incentives Reasonable accommodations Tobacco-free workplace

Tasks
  • Build customer relationships
  • Coordinate project implementations
  • Develop and execute strategic plans
  • Develop business partnerships
  • Drive up-sell and renewal activities
  • Ensure contract compliance
  • Identify additional service opportunities
  • Manage accounts and P&L
  • Manage financials and revenue
  • Manage talent and team
  • Monitor performance and satisfaction
  • Perform risk management
  • Project management
  • Resolve customer service issues
  • Review
  • Support client-specific pharmacy functions
  • Support clinical operations
Skills

Account Leadership Account management Account retention Analysis Benefit Analysis Benefit Optimization Benefits Business Business Development Care management Care Management Centers Claims Claims Payment Accuracy Claims processing Clinical operations Compensation Compliance Consultative Contract Compliance Contract management Contract Renewal Support Cost analysis Cost control Cost Solutions Customer needs assessment Customer Relationship Management Customer Satisfaction Customer service Data analysis Execution Financial analysis Financial Management Implementation Implementation management Interpersonal IT Leadership Legal and Regulatory Compliance Managed Care Operational Management Operations Partnership development Patient care Patient Care Enhancement Performance monitoring Pharmaceutical care Pharmacy Pharmacy Product Knowledge Pharmacy services Prior authorization Project Coordination Project Management Regulatory Compliance Relationship Management Revenue Management Risk Management Sales Sales Support Service Level Agreement Management Shared services Strategic Business Planning Strategic planning Talent Acquisition Talent Management Team Leadership Teams Therapeutics Up-Selling Upselling Strategies Utilization management

Experience

3 years

Education

Business Doctor of Pharmacy IT

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9