Michigan Clinical Account Manager - Remote

Posted Yesterday
Be an Early Applicant
Hiring Remotely in Home, PA, USA
In-Office or Remote
108K-184K Annually
Senior level
Insurance
The Role
Serve as the primary clinical account lead for assigned customers, driving pharmacy program value, contract compliance, financial performance, and customer satisfaction. Build strategic plans, manage account teams, support clinical operations and implementations, identify upsell opportunities, and ensure SLA and claims accuracy while managing P&L and talent development.
Summary Generated by Built In

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

Michigan Clinical Account Manager - RemoteJob Description

Innovative business clinician accountable for building and maintaining customer relationships as well as leadership of the account teams within all assigned accounts. Charged with delivering results that demonstrate value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract compliance.Accountable for developing and executing the strategic plan for their accounts in conjunction with sales and operations.

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.

Minimum Qualifications

  • Bachelors - Pharmacy
  • 2+ years of Management Leadership
  • 5+ years of Pharmacy

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

Additional 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.

Preferred Qualifications

  • Masters’ Degree
  • PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy

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 $108,000.00 - $184,000.00 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.

Skills Required

  • Bachelor's degree in Pharmacy
  • 2+ years of management leadership
  • 5+ years of pharmacy experience
  • Eligible to work in the United States without visa or residency sponsorship
  • Project management experience and knowledge of health plans
  • 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
  • Provider experience
  • Master's degree
  • PharmD or Doctor of Pharmacy; State Pharmacy Licensure

Prime Therapeutics Compensation & Benefits Highlights

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

  • Healthcare Strength Health coverage is described as comprehensive, with medical, dental, and vision options and plan designs that include low deductibles for some choices. Wellness screenings and related incentives add perceived value to the health offering.
  • Retirement Support Retirement benefits stand out through a 401(k) match that is characterized as generous and immediately vested. This structure improves the overall long-term value of the total rewards package.
  • Strong & Reliable Incentives Annual incentive bonuses are positioned as a meaningful component of total compensation and are often portrayed as substantial when performance goals are met. Incentive eligibility appears broadly available across roles, boosting the perceived completeness of rewards.

Prime Therapeutics Insights

Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Eagan, MN
3,577 Employees
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Follow Prime on LinkedIn to learn more.

Similar Jobs

Cox Enterprises Logo Cox Enterprises

Technical Customer Care Specialist I (Vin Solutions)

Artificial Intelligence • Automotive • Greentech • Information Technology • Machine Learning • Software • Cybersecurity
Remote or Hybrid
United States
50000 Employees
17-25 Hourly

Dragos Logo Dragos

Machine Learning Engineer

Security • Cybersecurity
Remote
United States
295 Employees
190K-190K Annually

Dragos Logo Dragos

Senior Capabilities Hunter

Security • Cybersecurity
Remote
United States
295 Employees
152K-152K Annually

Dragos Logo Dragos

Machine Learning Engineer

Security • Cybersecurity
Remote
United States
295 Employees
225K-225K Annually

Similar Companies Hiring

Globe Life Thumbnail
Insurance • Financial Services
McKinney, TX
3000 Employees
MassMutual India Thumbnail
Big Data • Fintech • Information Technology • Insurance • Financial Services
Hyderabad, Telangana
Granted Thumbnail
Artificial Intelligence • Healthtech • Insurance • Mobile • Financial Services
New York, New York
23 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account