Director – Clinical Strategy and Integrated Specialty Solutions - Remote

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Director, Clinical Strategy and Integrated Specialty Solutions - Remote

Job Description

The Director, Clinical Strategy and Integrated Specialty Solutions is responsible for shaping and executing the clinical strategy for pharmacy, medical and integrated products. This position leads the development and oversight of a comprehensive portfolio of Specialty clinical programs, driving innovation, measurable outcomes, and strategic alignment with business goals. This role serves as a Specialty subject matter expert and strategic partner, collaborating across clinical, technical, operational, and business teams to deliver innovative, scalable solutions and also collaborates with external stakeholders, ensuring the successful delivery of Specialty programs and contributing to the advancement of strategic business initiatives. This role may be responsible for the development and delivery of strategic business roadmaps for medical, pharmacy, or integrated specialty solutions.

Responsibilities

• Develop clinical solutions and strategic roadmaps for pharmacy, medical and integrated products; oversee the development and implementation of product solutions
• Lead or provide support to Specialty and Clinical program and product teams in development and maintenance of any additional specialty solutions
• Maintain knowledge of key economic and clinical industry trends
• Provide insight into competitor products and services
• Partner with the following stakeholders for:
  • Health Outcomes and Analytics teams: to manage/monitor data in areas such as trend/net trend, net ingredient cost, utilization % change, brand inflation, specialty network savings, formulary compliance, rebate/Rx, specialty network savings, Utilization Management (UM) savings for pharmacy and medical benefits, Reimbursement solutions, Site of Care, Coupons, 340b
  • Pharmacy Trade Relations: for collaboration on new programs that may impact manufacturer contracting, manufacturer contract performance and other areas as needed.
  • Pharmacy team: to serve as strategy partner for UM programs, medical policy, formulary, pipeline, P&T committee recommendations, maintenance of drug lists, etc.
  • Claims Operations and Clinical Operations for pharmacy and medical benefits
  • Technology and architecture
  • Networks: to develop and assist with product development and clinical strategy and management of therapeutic category performance and reporting
• May lead or support in presenting program results and solutions to Clients
• Other duties as assigned

Minimum Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree

• 3 years of pharmacy experience in a PBM, managed care, specialty pharmacy or cross-benefit management
• Current pharmacist license to practice in the applicable state(s)

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Ability to facilitate change
• Ability to develop relationships and influence at all organizational levels
• Demonstrated ability to distill complex concepts or situations into concise and compelling communications
• Critical thinking skills and ability to anticipate issues and develop innovative solutions
• Ability to travel 25%

Preferred Qualifications

• Advanced degree or Certification in specific therapeutic category
• Integrated Specialty: Medical and pharmacy drug management experience
• Integrated Specialty: Cross-functional project and/or product development, influencing leaders and business decisions

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.  

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.