Clinical Program Advisor – Clinical Operations

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

📋 Description

• Offer guidance, advice, thought leadership, and technical proficiency on key Clinical Program Management issues.

• Facilitate coordination among organizations and represent the company in external engagements.

• Educate and empower care coordination among stakeholders to enhance healthcare experiences and customer satisfaction.

• Act as a clinical advisor to the sales team, providing product and industry insights and education.

• Oversee client projects related to Medicare operational and implementation benefit changes.

• Comprehend clients’ current clinical benefits and business philosophies.

• Gather and document clinical benefit requirements alongside business stakeholders.

• Deliver exceptional customer service and establish trust as a client advisor.

• Collaborate with internal teams to evaluate, comprehend, and convey the implications of clinical benefit requirements.

• Supply operational subject matter expertise to Clinical Account Executives, Implementation Managers, Client Benefit Administrators, Clinical Application Teams, and Product Owners.

• Manage and monitor requests to ensure adherence to timelines.

• Cultivate a thorough understanding of claims adjudication systems and related clinical applications.

• Lead the creation, preparation, and presentation of project plans, ensuring execution and delivery for assigned clients.

• Engage in and contribute to both formal and informal training and professional development initiatives.

⛳️ Requirements

• Valid U.S. Pharmacist License.

• Pharm.D.

• At least 3 years of licensure experience preferred in managed care or prior PBM experience.

• Familiarity with the PBM industry, managed care, or value-based healthcare sectors is advantageous.

• Strong proficiency in Microsoft Excel and Access.

• Capability to manage multiple tasks, prioritize effectively, and resolve complex issues.

• Excellent project management abilities.

• Willingness to learn internal reporting and analytics tools.

• Skill in managing timelines and meeting stringent client deadlines.

• Advanced problem-solving capabilities.

• Ability to collaborate effectively with other departments.

• Capacity to work under pressure and maintain continual follow-up.

• Reliable home internet connection through cable broadband or fiber optic service with minimum speeds of 10Mbps download/5Mbps upload when working remotely.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Comprehensive medical benefits.

• Vision benefits.

• Dental benefits.

• Well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-sponsored life insurance.

• Tuition reimbursement program.

• Minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.

• Cable broadband or fiber optic internet service with minimum speeds of 10Mbps download/5Mbps upload for remote workers.