18X Special Forces Candidate

U.S. Army; Turney (MO); Remote; USD 150,000 - 210,000; Full time

Job summary

Prime Therapeutics (Prime) is seeking a Director of Specialty Clinical Solutions (Remote). The role leads clinical services, strategies, and partnerships with clients to optimize medical pharmacy and specialty programs.

You will drive data-driven decision making, program design, and performance reporting while collaborating with cross-functional teams. The position requires PharmD or PharmD-equivalent with 7+ years in medical pharmacy or health plans, U.S.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree.
• 7 years of work experience in medical pharmacy or health plan with multiple lines of business.
• Current pharmacist license to practice in the applicable state(s).
• Must be eligible to work in the United States without visa sponsorship.
• Strong communication, presentation, and stakeholder management skills.

Responsibilities

• Oversee clinical services and strategies within Medical Pharmacy & Specialty programs.
• Lead clinical consultants and provide strategic guidance to assigned clients.
• Collaborate with account management to support client retention and growth.
• Develop innovative medical pharmacy strategies using data-driven insights.
• Evaluate therapies and market trends to improve clinical outcomes and value.
• Manage client-facing programs including prior authorizations and utilization management.
• Create client-facing clinical materials and thought leadership content.
• Represent the organization as a clinical expert in industry settings.

Skills

Leadership

Communication

Presentation

Project management

Education

Doctor of Pharmacy (PharmD)

Bachelor of Science in Pharmacy

Tools

SQL

Data visualization (Tableau/Power BI)

Job description

Director, Specialty Clinical Solutions- REMOTE

Home
Full time
R-17419
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
Job Description
The Specialty Clinical Solutions Director Senior is responsible for overseeing the clinical services and strategies within the Medical Pharmacy & Specialty programs delivered to customers including clinical and utilization management, analysis, innovation, financial management, regulatory & quality compliance, and contractual obligations.
Responsibilities

• Serve as the lead clinical consultant and subject matter expert for assigned clients, providing strategic guidance on medical pharmacy and specialty programs
• Partner with account management and business development teams to support client retention, growth opportunities, financial analyses, and new business initiatives
• Develop and advance innovative medical pharmacy strategies through data-driven insights, clinical solution design, and program enhancements
• Evaluate emerging therapies, market trends, and medical benefit drug management opportunities to improve clinical outcomes, affordability, and client value
• Oversee client-facing medical pharmacy programs and utilization management solutions, including fee schedule management, prior authorization, post-service claim edits, and related programs
• Identify opportunities to expand existing programs and recommend new solutions that address evolving client and market needs
• Colloborate with cross-functional teams to evaluate program performance, develop business rules, deliver actionable insights, and drive continuous improvement through enhanced reporting and operational efficiencies
• Lead the development of client-facing clinical materials, strategic presentations, thought leadership content, and industry-facing publications
• Represent the organization as a clinical expert and mentor through industry engagement, enterprise initiatives, conference presentations, and guidance to peers and cross-functional partners
• Other duties as assigned

Minimum Qualifications
Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree
7 years of work experience in medical pharmacy or at Health Plan with multiple lines of business
Current pharmacist license to practice in the applicable state(s)
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
Strong interpersonal & communication, consultation, organizational, tracking and follow-up skills
Ability to research, obtain, coordinate, and integrate feedback from diverse operational groups
Excellent verbal and written communication skills
Strong presentation skills who exude high confidence in project output and production
Preferred Qualifications
Medical Pharmacy management, strategy & data interpretation experience at a health plan
Health plan experience managing drugs on both the Pharmacy and Medical benefit across all lines of business
Every employee must understand, comply with and at