Clinical Program Advisor – Clinical Operations

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

📋 Description

• Offer strategic advice and guidance to senior management on key Clinical Program Management issues

• Provide innovative insights and technical knowledge across various fields

• Facilitate coordination among different organizations and act as the company’s representative externally

• Educate and empower stakeholders for effective care coordination to enhance healthcare experiences and customer satisfaction

• Act as a clinical consultant to the sales team, sharing product and industry knowledge

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

• Comprehend clients’ clinical benefits and organizational philosophies

• Gather and document clinical benefit requirements in collaboration with business stakeholders

• Deliver exceptional customer service and build trust as a client advisor

• Collaborate internally to assess, comprehend, and communicate the implications of clinical benefit requirements

• Offer operational expertise to clinical, implementation, benefit administration, application, and product teams

• Monitor and manage requests to ensure deadlines are adhered to

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

• Spearhead the development, preparation, and presentation of project plans, ensuring successful execution and delivery

• Engage in and contribute to training and professional development initiatives

• Provide project and administrative support while addressing issues, risks, and concerns

⛳️ Requirements

• Valid U.S. Pharmacist License

• Pharm.D. degree

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

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

• Proficiency in Microsoft Office, particularly Excel and Access

• Ability to handle multiple tasks and communicate effectively

• Strong written and verbal communication skills, including active listening, providing feedback, and simplifying complex ideas/processes

• Skills in collaboration, analytical/critical thinking, results orientation, and organization

• Capable of managing several tasks, prioritizing, resolving complex issues, and demonstrating effective project management skills

• Willingness to learn internal reporting and analytic tools

• Ability to manage timelines and adhere to tight client deadlines

• Advanced problem-solving abilities

• Capability to work collaboratively across different departments

• Ability to perform well under pressure and maintain ongoing follow-up

• Home internet connection via cable broadband or fiber optic service with a minimum of 10 Mbps download and 5 Mbps upload speed

• Must be eligible to work in the United States

🏝️ Benefits

• Eligibility for an annual bonus plan

• Medical insurance coverage

• Vision insurance benefits

• Dental insurance options

• Well-being and behavioral health programs

• 401(k) retirement plan

• Company-funded life insurance

• Tuition reimbursement assistance

• A minimum of 18 days of paid time off each year

• Paid holidays

• Leave of absence provisions

• Opportunity for remote work arrangements

• Requirement for cable broadband or fiber optic internet for home-based work