Clinical Solutions Manager

Posted 11 Days Ago
Be an Early Applicant
San Diego, CA, USA
In-Office
69K-119K Annually
Senior level
Healthtech • Pharmaceutical
The Role
Manages clinical products and services throughout their lifecycle, including business analysis, product development, implementation, project management, process improvement, billing reconciliation, and client support. Leads cross-functional teams, documents requirements, monitors deliverables, supports sales opportunities, manages vendors and communications, and develops recommendations for clinical program and workflow improvements within a pharmacy benefits management organization.
Summary Generated by Built In

Exemption Status:United States of America (Exempt)

$68,571 - $93,600 - $118,628

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

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!

Job Description

The Clinical Solutions Manager I provides oversight and management of the operation workflows necessary throughout the lifecycle of clinical products and services in the areas of business analysis, product sale, implementation, billing reconciliation, project management, and business process improvement. The position supports the overall vision, goals, and objectives for the Clinical Services within the Health Services Department and liaisons with and across departments to ensure that assigned Strategic Business Initiatives, Business Unit Initiatives, product development and operational functions are successful, meet corporate operational excellence criteria and yield revenue to meet target goals.  This position works on assignments that are extremely complex in nature where independent action and a high degree of initiative are required in resolving problems and developing recommendations.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • Develop, build, and maintain departmental clinical programs, products and services that materially contribute to the profitability, growth and productivity of the department and the company.  Responsible for successful implementations and developing and maintaining operational plans.
  • Identify and analyze information and research solutions for leadership, management and staff teams for strategic and business unit initiatives and product development projects.  Responsible for evaluating, selecting and analyzing information about potential solutions, technologies, competitive market analyses and services. Utilize project management skills to track deliverables, timely notification of risk indicators and provide regular status updates to Leadership internally/externally.
  • Lead the research, development and implementation of clinical programs, products and services. Support cross-functional teams through all phases of the product and project lifecycle. Coordinate sessions to document business requirements, application needs, functionality, and user requirements.  Act as a liaison between functional work areas to develop consensus on product and project deliverables and monitor timeline(s) as required. Work through problem areas and ensure flawless implementation of programs by appropriate review and customer sign-off, leading conference calls, and completing other related responsibilities.
  • Act as a subject matter expect (SME) for clinical programs, products and services.  Provide day-to-day management of business, technology and marketing issues and deliverables of assigned clinical programs, products and services within the lifecycle process, ensuring timely and cost-effective delivery.  Rely on experience, judgment, business & systems knowledge, and technical skills to plan and accomplish goals.
  • Support organizational sales efforts for clinical products. Facilitate completion of opportunity analyses as requested for prospective and current clients. Assist Client Teams in completing Opportunity Analysis Questionnaires and validating test claims. Coordinate with other Clinical Solutions staff in delivery of opportunity analyses.
  • Promote continuous improvement by reviewing, analyzing, evaluating and re-designing complex, intricate business processes.  Use process mapping and other workflow simplification techniques to capture and define process efficiencies and ROI.
  • Effectively utilize the assets, tools, and processes necessary to achieve business objectives by leveraging analysis, evaluation, planning and organizational skills/tools.  Provide recommendations for the acquisition/development or enhancement of equipment and systems necessary to support the business in an efficient and quality manner.  Manage and update product toolkits to ensure that Sales and Account Management have up-to-date resources.
  • Support business process improvement initiatives, including evaluating and documenting processes and workflows, identifying gaps, and developing recommendations for improvement. Conduct needs assessments and gap analysis as required per initiative. Design, implement, and monitor required change management plan(s) to support business transitions.
  • Complete all documentation throughout the product or project lifecycle, including creating project charters, business cases, business requirements, functional requirements, etc. Obtain appropriate approvals at each phase of the project.  Retrieve information from a variety of sources, including but not limited to proprietary on-line databases, Internet, wire services and competitive market sources.  Utilize information retrieved to conduct research and analysis to derive implications from data and present results and information to leadership, product and project sponsor and teams and to oversee development of action plan(s). 
  • Coordinate and arrange for recruitment or assignment of project personnel, including SME’s, and other tangible and intangible resources necessary to complete analyses, define scope, create the project plan, and execute deliverables.  Ensure that assigned staff members understand roles & responsibilities and rules of engagement.
  • Manage outgoing communications associated with clinical products to internal account teams, Clients, and/or external vendors.  Attend Client calls when necessary, compile and send out Client reporting, and track Client billing/service agreements.  Monitor and audit vendor invoicing, reporting, and processes. Serve as a liaison between Clinical Service functional areas and ancillary business units, including Information Technology, Operations and Business Development to ensure timely project or product timelines.
  • Complete all documentation throughout the product or project lifecycle, including creating project charters, business cases, business requirements, functional requirements, etc.  Obtain appropriate approvals at each phase of the project.

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

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 3 years of SME in respective areas

Computer Skills

Intermediate to advanced proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Project, and Outlook) and Microsoft Visio.

Certificates, Licenses, Registrations

Possession of a current, active and unexpired clinical licensure (e.g., Registered Pharmacy Technician (RPhT), Licensed Practical Nurse (LPN), Certified Nursing Assistant (CNA)) or a nationally recognized certification (e.g., Certified Pharmacy Technician (CPhT), Medical Terminology Certification).

Project Management certification (e.g., PMP, CAPM, or equivalent) is highly desired.

Other Skills and Abilities

  • Strong understanding of PBM, managed care, and retail pharmacy along with pharmacy claims.
  • Outstanding numeric, verbal, written, logic, organizational and analytical skills
  • Skilled and knowledgeable in product and project life cycles and methodologies, continuous quality improvement, and change management.
  • Experience working with or in IT departments in the development and implementation of clinical software applications a plus.
  • Basic knowledge of operations, including scheduling, procurement, manufacturing, test engineering and quality systems.
  • Basic knowledge of finance, including ability to read and understand financial data such as product income statements, ROI analysis, net present value analysis.
  • Basic knowledge of marketing, including market research, market sizing, pricing, marketing communications and product launch.
  • Basic knowledge of new product development processes and methodologies.
  • Demonstrated experience utilizing Six Sigma principles or other data-driven process improvement methodologies.
  • Ability to manage multiple, concurrent projects.

Reasoning Ability

                                   

  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Mathematical Skills

     

  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Language Skills

  • Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. 

      

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

Composure

Decision Quality

Organizational Agility

Problem Solving

Customer Focus

Drive for Results

Peer Relations

Time Management

Dealing with Ambiguity

Learning on the Fly

Political Savvy

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. Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e., “close vision”) to accurately read fine print, view computer screens, and handle small objects. Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.

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 meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, 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 no travel; however, attendance may be required at various local conferences and meetings.

The Perks:
  • Medical / Dental / Vision / Wellness Programs

  • Paid Time Off / Company Paid Holidays

  • Incentive Compensation

  • 401K with Company match

  • Life and Disability Insurance

  • Tuition Reimbursement

  • Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA:

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

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Skills Required

  • Bachelor’s degree or equivalent combination of education and experience
  • At least 5 years of professional experience
  • At least 3 years of subject matter expertise in the applicable area
  • Intermediate to advanced proficiency in Microsoft Office Suite, including Word, Excel, PowerPoint, Project, and Outlook
  • Proficiency in Microsoft Visio
  • Current, active, and unexpired clinical license or nationally recognized clinical certification
  • Strong understanding of pharmacy benefit management, managed care, retail pharmacy, and pharmacy claims
  • Experience with product and project lifecycles, continuous quality improvement, and change management
  • Experience utilizing Six Sigma or other data-driven process improvement methodologies
  • Ability to manage multiple concurrent projects
  • Project management certification such as PMP or CAPM
  • Experience working with IT departments on clinical software application development and implementation

MedImpact Healthcare Systems Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about MedImpact Healthcare Systems and has not been reviewed or approved by MedImpact Healthcare Systems.

  • Fair & Transparent Compensation — Pay is considered fair for the job in some cases, and certain technical roles are competitively compensated. Feedback suggests total compensation can be solid depending on role and market.
  • Leave & Time Off Breadth — Time off includes PTO and 11 paid holidays, establishing a clear baseline. Feedback suggests accrual and holiday structures provide predictable time away.
  • Healthcare Strength — Health coverage is described as decent or competitive, with medical, dental, vision, HSA, and FSA options available. Feedback suggests core health benefits meet mainstream expectations.

MedImpact Healthcare Systems Insights

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The Company
HQ: San Diego, CA
1,400 Employees
Year Founded: 1989

What We Do

MedImpact, an independent, trend-focused pharmacy benefit manager (PBM), is the nation’s largest privately held PBM, serving health plans, self-funded employers and government entities. Our business model is unique. We focus on effectively managing client pharmacy benefits to promote Lower Cost and Better Care through One Source. Our model aligns us with our clients. We help promote prescribing of lower-net-cost, medically appropriate drugs with fulfillment at the most appropriate participating pharmacy providing competitive pricing, good value and high-quality service.

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