Clinical Account Executive - REMOTE

Southern Scripts•Orlando, FL

1d•Remote

About The Position

The Clinical Account Executive (CAE) will support pharmacy benefit management programs with the development of industry leading, highly managed clinical strategies including formulary development, utilization management, rules development, vendor management, and development of Southern Scripts’ Clinical Care Management product. The CAE will also be responsible for client relationships and will work collaboratively with account teams in support of Southern Scripts’ clients in order to improve the quality of care while controlling or decreasing overall health care costs.

Requirements

Ability to work independently.
Ability to translate clinical information into a manner appropriate for clinical and non-clinical audiences.
Ability to research and analyze medical literature, including drug information, disease states, and clinical practice guidelines, and apply sound clinical judgment.
Support the Clinical, Account Management, and Implementation teams
Maintain professional image and presence.
Adhere to all SS policies and procedures.
PharmD from an accredited College of Pharmacy; B.S. Pharmacy accepted.
Five (5) years of pharmacy experience working for a Health Plan or PBM.
Experience in client-facing role and client presentations.
Experience with utilization management including specialty medication management strategies, clinical program development, drug use evaluation, and formulary development and maintenance.
Excellent written and oral skills, both in developing materials and presenting to clients.
Ability to multi-task and work outside the clinical environment.
Exceptional clinical, business, and relationship building skills.

Nice To Haves

Completion of a pharmacy practice, managed care, or specialty residency.
Three (3) years of experience in analyzing raw prescription claims data.
Proficiency in using database information systems and Microsoft Office Suite.

Responsibilities

Develop new clinical strategies, as well as provide oversight of clinical programs developed internally and by third parties.
Analyze, interpret, and develop written recommendations using prescription claims data.
Participate in client implementation meetings.
Develop and maintain Client relationships to ensure needs are met and overall satisfaction.
Work collaboratively with Account Management to support client needs.
Develop client specific clinical recommendations to improve overall healthcare outcomes and control drug spend.
Investigate and resolve all client issues.
Proactively make recommendations for clients to stay ahead of the curve regarding drug pipeline activity.
Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations/supportive rationale for clinical management strategies.
Provide drug information as the clinical consultant/expert on the account team.
Provide operational subject matter expertise to Account Management and Implementation teams for clinically related programs.
Analyze and evaluate pharmacy data and reporting, as well as create/design ad-hoc reports.
Develop communication materials to both internal and external parties when necessary regarding formulary and utilization management changes, health literacy, medication adherence, and pharmacy trends.
Support the customer service department when clinical claim review is needed.
Effectively collaborate with cross-functional teams to build consensus among all departments while supporting overall goals and initiatives.
Perform other responsibilities and projects on as needed basis.
Abide by all obligations under HIPAA related to Protected Health Information (PHI).
If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.
Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.