Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Sr. Director Formulary Management- REMOTEJob Description
Responsible for clinical analysis and research activities related to the implementation and ongoing maintenance of formulary and utilization management programs. Key strategist responsible for ensuring all clients initiated, and internal clinical program and new clinical product implementation projects are accurately implemented and maintained.
Responsibilities
- Clinical expert for the organization in leading the development and delivery of medication utilization programs in support of total drug solutions.
- Prepares and presents clinical business strategy plan.
- Supports opportunities for new clinical products for the expansion and maximization of revenue growth.
- Client facing responsibilities related to leading the up sell of clinical program solutions and formulary related programs through consultative methods and processes (quarterly/annual reviews, modeling reviews, data warehouse reporting, etc.).
- Leadership oversight of P&T committee charter and membership.
- Consults with peers, business divisions, and business operations to troubleshoot and resolve issues associated with the marketing and sales, financial underwriting, implementation, reporting, etc. of clinical programs and services in support of business division goals and objectives.
- Management oversight of the clinical team responsible for the implementation and maintenance of drug formularies, utilization management algorithm/criteria input for Prior Authorization review.
- Provides strategic support and coaching to team members.
- Builds UM Clinical Development team; works to develop employee?s skills, evaluates performance and provide feedback, and oversees resolution of employee relations issues.
- Represents UM Clinical Development capabilities in RFP inquiries and sales finalist presentations.
- Acts as UM Clinical Development business owner; represents business needs for departmental system applications; collaborates with client facing teams to execute on client requests that impact operational tools.
- Partners with Benefit and Formulary Operations in test case requirements development and review for the quality testing of formulary updates and new utilization management programs.
- Other projects as assigned.
Education & Experience
- Education Level
- Bachelors - Pharmacy
- PharmD - Pharmacy
- Required
- Yes
- Yes
- Fields of Study
- Pharmacy
- Pharmacy
- Experience Level
- 10+ years
- 2+ years
- Required
- Yes
- Yes
- Details
- Pharmacy
- Management/Leadership
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Additional Qualifications
- 10+ years' experience in pharmacy, managed care or PBM with 3 or more years experience in a leadership role.
Preferred Qualifications
Physical Demands
- Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
- Must be able to constantly operate a computer and/or other office productivity equipment
- Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
- Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
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.
Potential pay for this position ranges from $143,000.00 - $243,000.00 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.
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 (pregnancy, sexual orientation, and gender identity), 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.
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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.
