Clinical Account Executive

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Assist in managing pharmacy benefit programs by formulating advanced clinical strategies, which encompass formulary development, utilization management, rules formulation, vendor oversight, and Liviniti’s Clinical Care Management product.

• Create innovative clinical strategies and supervise clinical programs that are developed internally and by external partners.

• Analyze, interpret, and produce written recommendations based on prescription claims data.

• Engage in client implementation meetings.

• Build and sustain client relationships to ensure requirements are fulfilled and satisfaction is preserved.

• Work collaboratively with Account Management to address client needs.

• Generate client-specific clinical recommendations aimed at enhancing healthcare outcomes and managing drug expenditures.

• Investigate and resolve client-related issues.

• Offer proactive recommendations concerning drug pipeline developments.

• Meet with clients to review clinical trends, analyze pharmacy data, and provide suggestions along with the rationale for clinical management strategies.

• Serve as the clinical consultant/expert on the account team, providing drug information.

• Offer operational expertise to Account Management and Implementation teams for clinical programs.

• Analyze and assess pharmacy data and reporting, creating and designing ad-hoc reports.

• Develop communication materials related to formulary and utilization management changes, health literacy, medication adherence, and pharmacy trends.

• Assist customer service when a clinical claim review is required.

• Collaborate with cross-functional teams to reach consensus and support organizational objectives.

• Comply with HIPAA regulations regarding Protected Health Information (PHI), report any identified violations, and complete necessary HIPAA training.

• Undertake additional responsibilities and projects as required.

⛳️ Requirements

• PharmD from an accredited College of Pharmacy; B.S. Pharmacy is also accepted.

• A minimum of five (5) years of pharmacy experience in a Health Plan or PBM.

• Experience in a client-facing role with client presentations.

• Proficient in utilization management, including specialty medication management strategies, clinical program development, drug use evaluation, and formulary development and maintenance.

• Outstanding written and verbal communication skills for material development and client presentations.

• Ability to manage multiple tasks and work outside of the clinical setting.

• Exceptional clinical, business acumen, and relationship-building skills.

• Capability to work independently.

• Skilled at translating clinical information for both clinical and non-clinical audiences.

• Proficient in researching and analyzing medical literature, including drug information, disease states, and clinical practice guidelines while exercising sound clinical judgment.

• Support the Clinical, Account Management, and Implementation teams.

• Maintain a professional image and presence.

• Adhere to all SS policies and procedures.

• Completion of a pharmacy practice, managed care, or specialty residency is preferred.

• Preferred: Three (3) years of experience in analyzing raw prescription claims data.

• Preferred: Proficiency in database information systems and Microsoft Office Suite.

• Ability to work during core hours of 8:00 AM to 5:00 PM CT and adjust work hours to accommodate meetings across all time zones.

• Willingness to work extended hours, weekends, and holidays as demanded by the industry.

• Up to 10% - 25% travel may be required, including travel outside the local area and overnight stays.

🏝️ Benefits

• Medical, Dental, and Vision insurance.

• Disability and Life insurance.

• Employee Assistance Program.

• Options for remote work.

• Generous Paid-Time Off.

• Annual Reviews and Development Plans.

• Retirement Plan with company match; immediate 100% vesting.