Full-Time

Clinical Account Manager

Multiple Teams

Posted on 9/24/2025

Prime Therapeutics

Prime Therapeutics

1,001-5,000 employees

Pharmacy benefits management and drug programs

Compensation Overview

$108k - $184k/yr

No H1B Sponsorship

Remote in USA

Remote

Candidates must be eligible to work in the United States without the need for work visa or residency sponsorship.

Category
Sales & Account Management (1)
Required Skills
Sales
Risk Management
Customer Service
Requirements
  • PharmD or Bachelor of Science Pharmacy degree
  • Current Pharmacist license to practice in the applicable state(s)
  • 1 year work experience in Pharmacy
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship
Responsibilities
  • Performs customer centric pharmacy services.
  • Owns overall account satisfaction for all assigned accounts.
  • Develops strong relationships with pharmacy department or designated customer contacts.
  • Directs operations account manager in resolving customer service issues and actions supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
  • Maintains knowledge in all aspects of the contracts with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment.
  • Creates and maintains partnerships with customers through the development, implementation and execution of strategic business plans that result in long term retention of profitable relationships.
  • Ensures all Customer and Account-Facing services are provided in a consistent and timely fashion.
  • Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement).
  • Identifies opportunities for additional services that address unmet customer needs.
  • Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and programs and provides support to client-specific Pharmacy and Therapeutics functions, DUR committees and responsibilities.
  • Supports elevated customer service and prior authorization inquiries specific to assigned accounts.
  • Manages financial aspects of account(s).
  • Ensures revenue goals are met, cost of care and administrative expenses managed, and EBIDTA targets achieved for the assigned account(s).
  • Ensures contract performance through risk management activities including such items as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment.
  • Develops opportunities: Seeks and identifies pharmacy products and service requirements based on a thorough understanding of each customer's strategic business goals and the strategic business direction of the product set.
  • Aggressively drives up-sell of pharmacy program solutions through consultative methods and ensures flawless handoff to sales and relationship management for contract execution.
  • Supports sales and account management in renewal activities related to assigned accounts.
  • Manages talent: Accountable for identifying creative talent to serve the account, as well as retention of high performing team members.
  • Ensures staff is trained and receive opportunities to learn new things.
Desired Qualifications
  • 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency.
  • Proven ability to plan, organize, schedule, direct, control and monitor project activities.
  • Well-developed interpersonal skills.
  • Able to perform basic financial analysis.
  • Project management experience and knowledge of health plans required.
  • Provider experience preferred.

Prime Therapeutics provides pharmacy benefit management, specialty and medical drug management, and state government drug solutions for millions of people. It helps health plans and government programs control drug benefits by negotiating discounts, designing formularies, processing claims, and overseeing utilization to ensure safe and appropriate use of medications. It combines traditional PBM services with specialty and medical drug programs and a focus on government solutions to serve both private and public payers. Its goal is to deliver savings, simplicity, and support that help people achieve better health.

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Eagan, Minnesota

Founded

1987

Simplify Jobs

Simplify's Take

What believers are saying

  • GLP-1 research at AMCP 2025 establishes leadership in high-growth diabetes market.
  • Humira biosimilar solutions provide cost-effective flexibility post-patent expiration.
  • CIO Dinesh Kandanchatha hired July 2024 drives digital transformation with 25-year expertise.

What critics are saying

  • Michigan AG Nessel's May 2024 lawsuit imposes fines for anticompetitive pharmacy suppression.
  • FTC 2025 rules mandate rebate pass-through, slashing Prime's spread pricing profits.
  • Express Scripts erodes Prime's 10.3% share through GLP-1 and specialty expansions.

What makes Prime Therapeutics unique

  • Sempre Health partnership expands nationwide after $4.7M Blue Cross NC savings since 2022.
  • Pharmacy Match launched June 2024 uses real-time pricing for specialty pharmacy competition.
  • PreserveRx reinsurance with BCS Financial manages gene therapy costs since 2020.

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Benefits

Remote Work Options

Company News

Prime Therapeutics
Jan 12th, 2026
Prime's creative and brand work receives industry recognition

Prime's creative and brand work receives industry recognition. Prime Therapeutics creative services team wins 12 platinum and eight gold marcom awards. After Prime Therapeutics (Prime) announced its bold new brand and purpose to reimagine pharmacy solutions last year, Prime continues to show up as a different kind of pharmacy benefit management (PBM), including through its award-winning visual identity and messaging. The brand identity work recently received sweeping recognition from the 2025 Marcom Awards, which recognizes excellence in marketing and communications, as well as from the 2025 Graphic Design USA (GDUSA) American Inhouse Design Awards, which showcases outstanding design work. "These awards speak to the importance of how Prime shows up in the marketplace," said David Mitchell, vice president, marketing. "It's critical that our marketing and creative work reflects our brand's purpose, vision and culture." "These recognitions are truly a collaborative win across our marketing department and throughout Prime as an enterprise," he added. "I am so grateful for my team's work bringing Prime's distinctive identity to life." Prime recently received 12 platinum and eight gold marcom Awards, which recognized Prime's industry-leading creative work. GDUSA American Inhouse Design Awards. Earlier this year, the Creative team also earned 10 Graphic Design USA (GDUSA) American Inhouse Design Awards. These awards recognized the compelling new brand look and feel that represented Prime's transformation in the marketplace. This year marks Prime's 12th year of recognition, with nearly 100 GDUSA awards won to date. * 2024 President's Awards * Pharmacy Summit Branding * Reimagining The Board of Directors Suite * The Prime Rebrand * Its Solutions: Save, Simplify, Support * Brand Anthem: Transformation * Specialty Summit Environmental Graphics * Pharmacy Friends Social Media * Reimagining Its Website * Prime Cares & Prime Foundation Branding

Healthcare Finance News
Nov 2nd, 2025
Prime Therapeutics expands Sempre Health partnership to rein in drug costs

Prime Therapeutics expands Sempre Health partnership to rein in drug costs. The initiative has generated $4.7 million in member savings since its inception. Pharmacy benefit manager Prime Therapeutics is expanding its partnership with Sempre Health, a company that applies discounts at the pharmacy counter for people taking single-source drugs for chronic conditions. The initiative, focusing on expanding access to behavior-based medications, is meant to give clients new ways to help their commercial members save money and stay on therapy. Recent data from Prime's client, Blue Cross and Blue Shield of North Carolina, shows positive results from the model. Since launching in 2022, the program has enrolled more than 19,500 patients, supported over 70,000 prescription fills and generated $4.7 million in member savings. The initiative also achieved a Net Promoter Score of 98 and increased medication adherence by 15 percentage points, according to Prime. "The outcomes with Blue Cross NC and Sempre show exactly why we invest in initiatives like this: to make healthcare more affordable, improve adherence and support healthier lives," said Christopher Saliba, vice president of Enterprise Solutions at Prime. The companies will be expanding the model nationwide. Prime shared data from KFF showing that nearly 30% of Americans skip prescriptions due to cost, driving an estimated $290 billion in avoidable medical expenses each year. Sempre's behavior-based pricing model rewards healthy behaviors like timely refills and sustained adherence through partnerships with health plans, life science companies and pharmacy benefit managers (PBMs), including Prime. "Too many people are forced to choose between paying their bills and filling their prescription," said Anurati Mathur, CEO of Sempre Health. "Our work with Prime Therapeutics means that millions of people can stay on their life-saving medications without financial strain. We're thrilled to scale this impact nationwide." Prime Therapeutics is one of the largest PBMs in the country, with about a 10.3% market share, according to American Hospital Association data published last fall. Along with CVS Health (with a 21.3% market share), OptumRx (20.8%) and Express Scripts (17.1%), the country's four largest PBMs control roughly 70% of the national market. Michigan Attorney General Dana Nessel filed a lawsuit against Express Scripts and Prime Therapeutics in May, claiming the two pharmacy benefit managers allegedly engaged in anticompetitive conduct that harmed independent pharmacies in the state. According to the lawsuit, the PBMs allegedly formed an unlawful agreement that suppressed reimbursement rates to independent pharmacies, enabling them to pull in profits at the expense of independent pharmacies. Jeff Lagasse is editor of Healthcare Finance News. Healthcare Finance News is a HIMSS Media publication.

PR Newswire
May 28th, 2025
Flytehealth Obesity Care Program Demonstrates Cost Avoidance And Noteworthy Medication Adherence In Year-One Outcomes

NEW CANAAN, Conn., May 28, 2025 /PRNewswire/ -- FlyteHealth, a leading virtual cardiometabolic care provider, announced year-one outcomes from its Comprehensive Obesity Care program in an analysis performed on its customer, the State of Connecticut, which implemented the obesity care program for its employee health plan consisting of employees and retirees. In the study, FlyteHealth's approach was found to have an 86% adherence rate among new GLP-1 users and cost avoidance of up to $1.2 million within the pilot year of the program. This independent study was conducted by the actuarial consulting firm Milliman. The analysis examined the program's impact on pharmaceutical utilization, identifying immediate pharmacy benefit cost avoidance and noteworthy rates of treatment adherence among new GLP-1 utilizers in the State of Connecticut employee health plan.FlyteHealth's cardiometabolic offering delivers individualized therapy for obesity and three key cardiometabolic comorbidities (prediabetes, hypertension, and hyperlipidemia) through a patent-pending AI algorithm that informs patient-specific treatment plans. Based on over 30 years of clinical obesity care expertise from world-renowned obesity expert Dr. Louis Aronne, M.D., the treatment model combines personalized virtual care from a multidisciplinary team — including board-certified obesity medicine physicians, nurse practitioners and dietitians — precision pharmacotherapy, and intensive lifestyle coaching

KTBS
Mar 31st, 2025
Prime Therapeutics highlights industry-leading GLP-1 research at AMCP 2025

Prime Therapeutics highlights industry-leading GLP-1 research at AMCP 2025.

Times-Herald
Oct 7th, 2024
Prime Therapeutics announces new, cost-effective Humira(R) biosimilar solutions, offering clients flexibility and choice

Prime Therapeutics announces new, cost-effective Humira(R) biosimilar solutions, offering clients flexibility and choice.

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