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 analysts and support staff in clinical operations.

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

• Manage operational support for specialty programs, Pathwell, preventive initiatives, and other high-maintenance clinical projects.

• Create operational processes for products and projects while establishing sustainable maintenance models.

• Transition ongoing process ownership to the relevant operational teams.

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

• Propel automation and AI solutions to enhance efficiency, data integrity, workflows, and scalability.

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

• Execute custom client requests, set up utilization management, maintain drug lists, and provide 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 plans.

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

• Support audit preparedness, quality reviews, compliance efforts, 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 to enhance team capabilities.

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

⛳️ Requirements

• Pharmacy degree (BSPharm or PharmD).

• Active pharmacist license in good standing.

• At least five years of experience in healthcare, pharmacy benefit management, clinical operations, or a related field.

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

• Strong understanding of high-effort products and operational maintenance processes.

• Minimum of two years of leadership or people-management experience.

• Capability to lead operational teams in a complex, matrixed environment.

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

• Excellent verbal and written communication skills.

• Ability to manage multiple priorities and competing deadlines effectively.

• Proficiency in influencing business, operational, and technical stakeholders.

• Proficient in Microsoft Office, including Excel and PowerPoint.

• Preferred: experience in pharmacy benefit management, formulary management, utilization management, or clinical configuration.

• Preferred: experience supporting specialty pharmacy programs and custom client implementations.

• Preferred: knowledge of DCRS, CRS, FRS, Polaris, FIT, or related clinical configuration systems.

• Preferred: experience working with offshore or geographically distributed teams.

• Preferred: background in pharmacy, healthcare operations, or clinical program management.

• For remote work: cable broadband or fiber optic internet service with a minimum of 10 Mbps download/5 Mbps upload.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits.

• Programs for well-being and behavioral health.

• 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement.

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

• Paid holidays.

• Leaves of absence.