Clinical Account Manager

MedOne Pharmacy Benefit Solutions; Dubuque (IA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary and bonuses

Health, dental, and vision insurance

401(k) with company match

Generous paid time off and holidays

Professional growth opportunities

Collaborative work culture

Job summary

MedOne Pharmacy Benefit Solutions seeks a Clinical Account Manager to support clinical aspects of the business by working with patients, medical professionals, plan sponsors, and the MedOne team under the Director of Clinical Account Management.

The role focuses on coordinating clinical relationships, supporting sales, and assisting in reviews of specialty drugs and prior authorizations to optimize outcomes and cost efficiency. A strong communicator with PBM knowledge is essential.

Qualifications

• Bachelor’s Degree in Pharmacy or PharmD with current unrestricted licensure as a pharmacist.
• At least 2 years’ experience in a client-facing or consultative role within managed care or PBM.
• Ability to translate clinical information for clinical and non-clinical audiences.
• Strong problem-solving skills and ability to identify and implement solutions.
• Strong organizational, verbal and written communication skills with attention to detail.
• Proficient in drug literature and clinical trial evaluation.
• Ability to work with a team.
• MS Office products including Teams, Word, PowerPoint and Excel.
• Knowledge of the PBM industry, formulary management, pharmacy claims and managed care principles.
• Residency experience is highly preferred.

Responsibilities

• Coordinate and manage the clinical relationships between MedOne and clients.
• Assist Sales and Account Management in promoting clinical programs.
• Support client presentations with a focus on optimizing drug mix and cost containment.
• Review and sign off on specialty drug and appeal reviews for assigned clients.
• Communicate specialty drug approvals, therapy appropriateness, duration and cost of treatment.
• Communicate patient and financial impact for adverse determinations.
• Provide clinical consultation to maximize client retention.
• Inform clients about formulary and clinical program changes.
• Assist in clinical reviews and prior authorization processes with rationale and alternatives.
• Perform drug utilization reviews (concurrent, retrospective, prospective).
• Support patient calls requiring pharmacist intervention and meetings with clients.
• Interface with physicians, pharmacists, and providers for patients and clients.
• Create and maintain clinical content for MedOne programs.

Skills

Strong communicator

Problem solving

Organizational skills

Attention to detail

Team player

MS Office proficiency

Education

Bachelor’s Degree in Pharmacy or PharmD with licensure

Residency experience preferred

Tools

Teams

Word

PowerPoint

Excel

Job description

The Clinical Account Manager will support all clinical aspects of the business by working directly with patients, medical professionals, plan sponsors and the other members of the MedOne team under the direction of the Director of Clinical Account Management.

About MedOne:

MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.

What You Will Do at MedOne:

• Coordinates and manages the clinical relationships between MedOne Pharmacy Benefit Solutions and our clients
• Assists the Sales and Account Management departments in promoting clinical programs to support the needs of current and future clients and/or strategic partners
• Works in collaboration with Account Executives to support client presentations, with a focus on optimizing the drug mix, clinical improvement recommendations and cost containment strategies
• Responsible for review and signoff on specialty drug and appeal reviews for assigned clients
• Responsible for communicating specialty drug approvals, with an emphasis on the appropriateness and necessity of therapy, duration, and cost of treatment, and expected and actualized patient outcomes for assigned clients
• Responsible for communicating patient and financial impact and outcomes for adverse determinations for assigned clients
• Provides exceptional clinical consultation and clinical account management with a focus on attempting to exceed client expectations to maximize client retention
• Effectively communicates formulary and clinical program changes to client
• Assists in managing and conducting the clinical review/prior authorization process, including communicating clinical rationale, formulary therapeutic alternatives, and appeals process to members
• Performs duties related to drug utilization review including concurrent, retrospective, and prospective components
• Supports Member Experience and Account Management teams with phone calls from patients requiring pharmacist intervention and in-person meetings with clients
• Interfaces with physicians, pharmacists, and pharmacy providers on behalf of patients and clients
• Creates and maintains, as subject matter expert, clinical content for new and existing MedOne programs
• Assists the Director of Account Management, in addition to other MedOne team members with general business operations related to clinical functions
• Portrays the company in a positive image
• Abides by all rules, regulations, and policies of the employer
• Suports in furthering the profession of pharmacy through participation in the MedOne Student Internship Program

What you will bring to MedOne:

• Minimum of a Bachelor’s Degree in Pharmacy or PharmD with current unrestricted licensure as a pharmacist
• At least 2 years’ experience in a client facing or consultative role within the managed care or PBM setting
• Must be a strong communicator with the ability to translate clinical information into a manner appropriate for both clinical and non-clinical audiences
• High degree of emphasis on problem-solving skills, including identifying and accepting a challenging situation and creating and implementing a solution
• Strong organizational, verbal and written communication skills with emphasis on attention to detail
• Proficient in drug literature and clinical trial evaluation
• Ability to work with a team
• Strong working knowledge of Microsoft Office products including Teams, Word, PowerPoint and Excel
• Knowledge of the PBM industry, formulary management, pharmacy claims and managed care principles and practices
• Residency experience is highly preferred

Why Join MedOne?

• Competitive salary and bonuses that reward your performance
• Comprehensive health, dental, and vision insurance
• 401(k) with company match to secure your future
• Generous paid time off and holidays
• Opportunities for professional growth and development
• A vibrant and collaborative work culture