Sr Manager, Clinical Consulting & Plan Performance

Job Summary:

The Senior Manager of Pharmacy Clinical Consulting and Plan Performance is responsible for managing clinical consulting services and improving the performance of partner plans. This role will work closely with internal teams and external stakeholders to drive initiatives that enhance clinical outcomes, cost efficiency, and overall plan performance. As a subject matter expert (SME), the Senior Manager will provide clinical guidance and collaborate across departments to meet client goals.

Key Responsibilities:

Leadership and Strategy:

• Support the development and implementation of strategies to ensure client plan performance commitments are met.
• Act as a clinical SME to the client services team, providing operational guidance and day-to-day management support. 
• Collaborate with internal leaders to align clinical consulting efforts with organizational goals.

Clinical Consulting Services:

• Deliver high-quality clinical consulting services to clients, ensuring evidence-based recommendations.
• Assist in the development and implementation of clinical programs to improve patient outcomes and support client strategies.
• Support clinical discussions with clients during sales, implementations, and ongoing operations including how benefit designs and clinical programs impact financial performance.

Plan Performance Optimization:

• Analyze pharmacy benefit plan performance metrics to identify trends and areas for improvement.
• Collaborate with internal teams to identify and execute performance improvement strategies and report on outcomes.
• Provide day-to-day support and guidance to the client services team in managing client relationships and performance.

Stakeholder Collaboration:

• Build and maintain effective relationships with clients, internal teams, and external stakeholders.
• Serve as a resource to the client services team in discussing clinical strategies and performance improvements with clients.
• Participate in client meetings, presentations, and consultations to support ongoing client engagement.
• Act as a liaison between clients and internal teams, ensuring clear communication and alignment on goals.

Compliance and Quality Assurance:

• Support quality assurance efforts to ensure the accuracy and effectiveness of clinical consulting services.
• Stay updated on industry trends and best practices in pharmacy, PBM, and healthcare, ensuring continuous improvement.

Qualifications:

• PharmD or equivalent degree from an accredited institution.
• Active pharmacist license in good standing.
• Minimum of 7 years of experience in PBM, health plan, pharmacy clinical consulting, or a related field.
• Proven ability to manage projects and collaborate effectively with cross-functional teams.
• Strong analytical skills with the ability to interpret data and develop actionable insights.
• Excellent communication and interpersonal skills, with the ability to build relationships with clients and internal stakeholders.
• In-depth knowledge of pharmacy benefit management and clinical pharmacy practices.

Preferred Qualifications:

• Experience with project management and process improvement methodologies.
• MBA, MPH, or a related advanced degree is a plus.
• Previous experience working with health plans or PBMs is preferred.
• Located in CST or PST time zones.

Working Conditions:

• Remote-based with occasional travel for client meetings, conferences, and professional development.

SALARY (BEFORE COMMISSION POTENTIAL):  $130,000 - $140,000

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. 

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017, Rightway has raised over $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with a satellite office in Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values:

1) We are human, first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.

2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.

4) We cultivate grit
Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.

5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.

Rightway is PROUDLY an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.