Simplifying the healthcare experience for clients and members.
Senior Manager, Clinical Consulting – Plan Performance
Location
Florida
Posted
54 days ago
Salary
$130K - $150K / year
Seniority
Senior
Job Description
Senior Manager, Clinical Consulting – Plan Performance
Rightway
• Support the development and implementation of strategies to ensure client plan performance commitments are met. • Act as a clinical SME to the client services team, providing operational guidance and day-to-day management support. • Collaborate with internal leaders to align clinical consulting efforts with organizational goals. • Deliver high-quality clinical consulting services to clients, ensuring evidence-based recommendations. • Assist in the development and implementation of clinical programs to improve patient outcomes and support client strategies. • Support clinical discussions with clients during sales, implementations, and ongoing operations including how benefit designs and clinical programs impact financial performance. • Analyze pharmacy benefit plan performance metrics to identify trends and areas for improvement. • Collaborate with internal teams to identify and execute performance improvement strategies and report on outcomes. • Provide day-to-day support and guidance to the client services team in managing client relationships and performance. • Build and maintain effective relationships with clients, internal teams, and external stakeholders. • Serve as a resource to the client services team in discussing clinical strategies and performance improvements with clients. • Participate in client meetings, presentations, and consultations to support ongoing client engagement. • Act as a liaison between clients and internal teams, ensuring clear communication and alignment on goals. • Support quality assurance efforts to ensure the accuracy and effectiveness of clinical consulting services. • Stay updated on industry trends and best practices in pharmacy, PBM, and healthcare, ensuring continuous improvement.
Job Requirements
- PharmD or equivalent degree from an accredited institution.
- Active pharmacist license in good standing.
- Minimum of 7 years of experience in PBM, health plan, pharmacy clinical consulting, or a related field.
- Proven ability to manage projects and collaborate effectively with cross-functional teams.
- Strong analytical skills with the ability to interpret data and develop actionable insights.
- Excellent communication and interpersonal skills, with the ability to build relationships with clients and internal stakeholders.
- In-depth knowledge of pharmacy benefit management and clinical pharmacy practices.
- Experience with project management and process improvement methodologies is a plus.
- Managed Care Pharmacy Residency, MBA, MPH, or a related advanced degree is a plus.
- Previous experience working with health plans or PBMs is preferred.
Benefits
- Remote-based with occasional travel for client meetings, conferences, and professional development.
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