Clinical Program Manager

Clinical Program Manager

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

The Clinical Program Manager (CPM) will have a solid working knowledge of Medicaid program pharmacy coverage and payment rules and possess relevant experience in managing accounts and clinical projects. This pharmacist will attend onsite meetings at the state office building upon client's request and maintain responsibility for managing all aspects of the preferred drug list and supplemental rebate administration.

In addition to account / contract management responsibilities, this position also works to optimize the clinical quality and cost-effectiveness of drug therapy for a state Medicaid agency and their members. The focus is on rational management of drug utilization by employing analytical tools and an evidence-based approach to achieve lower net cost, better health outcomes, and high levels of satisfaction for plan sponsors and their members. The position works within corporate resources to achieve overall account and company financial goals. Relies on data and performance indicators, as well as experience and judgment, to identify and promote performance improvement opportunities which attain the aligned goals of MedImpact and the client.

Essential duties and responsibilities include the following. Other duties may be assigned.

• Oversight of all contract requirements, including but not limited to all services, deliverables, and oversight of both internal and subcontractor operations. This includes oversight of preferred drug list (PDL) development, maintenance and drug manufacturer invoicing team and rate-setting team.
• Serve as main point of contact for the account. Works with and oversees a diverse set of professional staff to fulfill contract requirements, including oversight of any subcontracts and their performance.
• Provides recommendations to assigned clients that align with the clients' goals of lower net costs and high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, P&T support and participation, recommendations for rational drug PDL positioning, on-line system edits and restrictions, on-going clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends.
• Provides clinical and Medicaid consultative services in accordance with contracted clinical and consultative services. Acts as an integral part of designing, developing, and driving the clinical components of assigned account team's strategic and financial goals. The CPM's focus will be centered on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously improve the plan sponsor's quality-focused and financial performance metrics.
• Identifies and promotes MedImpact's evidence-based interventions and communication programs to clients. Provides documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g. rebate enhancement, lower net cost, generic programs, QA programs).
• Recommends clinically appropriate PDL changes by while considering the lowest net cost after rebates, market shifts and utilization.
• Coordinates clinical utilization analyses and presentations to clients. Ensures timely and accurate review of plan data, according to policy, with appropriate intervention recommendations.
• Coordinates clinical support of Preferred Drug Lists during plan sponsor's implementation.
• Participates in quarterly state P&T meetings as per client contract.

Supervisory responsibilities : No supervisory responsibilities

Client responsibilities : This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening / verbal / written). One must be able to; manage difficult or emotional client situations; respond promptly to client needs; solicit client feedback to improve service; respond to requests for service and assistance from clients; meet commitments to clients.

Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience : PharmD and 3+ years' experience or equivalent combination of education and experience, and 1 year of SME in respective areas

Computer Skills : To perform this job successfully, an individual should have knowledge of Microsoft Office Suite and a working knowledge of relational databases.

Certificates, Licenses, Registrations : Registered Pharmacist in the State of Mississippi. If licensure is in an equivalent state, must have the ability to obtain a MS license within 6 months of the start of employment.

Other Skills and Abilities :

Reasoning Ability :

Mathematical Skills :

Language Skills :

Competencies : To perform the job successfully, an individual should demonstrate the following competencies :

Physical Demands : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and / or move up to 25 pounds.

Work Environment : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples : business office with computers and printers, light traffic).

Work Location : This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours : This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8 : 00am to 5 : 00pm.

Travel : This position requires both domestic and international travel of