Pharmacist - Clinical Advisor
Core
Client-facing clinical advisor managing relationships with health plan decision-makers to drive profitability, growth, and chronic disease management strategies.
Role type
Senior client-facing clinical advisor (pharmacy benefit management)
Builds
Comprehensive business plans, custom formulary options, utilization management programs, and specialty drug strategies for health plan clients.
Domain
Health insurance / Pharmacy Benefit Management (PBM)
Deliverable
client delivery
Required skills
Managed care pharmacy experience, utilization management, formulary management, clinical program development, data analysis, regulatory compliance, client relationship management, financial target achievement.
Preferred skills
PBM client support experience, expertise in Medicare/Medicaid/Exchange/Commercial segments, leadership skills, business acumen, knowledge of PBM adjudication engines, AMCP certification.
Technologies
PBM adjudication engines, ANCS, clinical and financial reporting systems
Responsibilities
Manage clinical relationships with health plan leaders; analyze marketplace conditions to develop business plans; recommend formulary and utilization management strategies; collaborate on custom clinical programs; consult on drug trends and pipeline; ensure regulatory compliance; meet client value and satisfaction targets.
Seniority
Senior, hands-on IC with client management