Clinical Program Manager – Clinical Operations Support, Custom Services

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

📋 Description

• Lead, mentor, and develop clinical operations analysts and support personnel.

• Supervise Clinical Operations Support Services, Specialty, Analyst Support Services, and Custom Support Services activities.

• Manage operational support for specialty programs, Pathwell, preventive programs, and other complex clinical initiatives.

• Create new operational processes, establish sustainable maintenance models, and transition ownership to operational teams.

• Collect requirements, evaluate operational impacts, and formulate implementation strategies with matrix stakeholders.

• Propel continuous improvement through automation and AI solutions.

• Oversee and assist with Rx Configuration PBAB requests, including exception reviews, consultations, risk assessments, and feasibility studies.

• Ensure the precise and timely execution of custom client requests, utilization management setups, drug list maintenance, and operational support services.

• Develop and uphold standard operating procedures, job aids, governance processes, and team documentation.

• Manage issue resolution, escalations, risk identification, and corrective action strategies.

• Collaborate with technology, product, implementation, and operational partners on products, enhancements, and strategic initiatives.

• Support audit preparedness, quality reviews, compliance activities, and operational controls.

• Monitor operational performance, service levels, capacity, and workload distribution.

• Lead cross-functional projects and organizational initiatives.

• Identify staffing, training, and development needs while enhancing team capabilities.

• Promote collaboration, accountability, adaptability, innovation, and continuous improvement.

⛳️ Requirements

• Pharmacy degree (BSPharm or PharmD).

• Active pharmacist license in good standing.

• Five or more years of experience in healthcare, pharmacy benefit management, clinical operations, or a related field.

• Relevant experience in supporting custom client programs and solutions within pharmacy benefit management or clinical operations.

• Strong understanding of high-effort products and the operational processes necessary for their maintenance.

• Two or more years of leadership or people-management experience.

• Proven ability to lead operational teams in a highly matrixed environment.

• Strong project management, organizational, analytical, and problem-solving abilities.

• Excellent verbal and written communication skills.

• Capability to manage multiple priorities and competing deadlines.

• Ability to influence stakeholders across business, operational, and technical domains.

• Proficient in Microsoft Office, including Excel and PowerPoint.

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

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical insurance.

• Vision insurance.

• Dental insurance.

• Well-being and behavioral health programs.

• 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement.

• Minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence.