Director, Specialty Clinical Solutions- REMOTE

Praxy; Northern (KY); Remote; USD 143,000 - 243,000; Full time

Job summary

Prime Therapeutics LLC is seeking a Director, Specialty Clinical Solutions - REMOTE to lead clinical services and strategies within Medical Pharmacy & Specialty programs across clients. You will guide utilization management, financials, regulatory compliance, and contract obligations while collaborating with account teams to drive client value.

The role requires PharmD or BS Pharmacy with extensive medical pharmacy experience, licensure, and a track record in program design, analytics, and

Qualifications

• Strong leadership and strategic consulting skills.
• Ability to design and implement clinical pharmacy strategies.
• Excellent communication and stakeholder management.

Responsibilities

• Oversee clinical services and strategies within Medical Pharmacy & Specialty programs.
• Provide strategic guidance to clients on medical pharmacy and specialty programs.
• Collaborate with account management to support client retention and growth.
• Develop and advance innovative medical pharmacy strategies using data-driven insights.
• Evaluate emerging therapies and market trends to improve outcomes and value.
• Lead development of client-facing clinical materials and publications.
• Represent the organization as a clinical expert in industry engagements.

Skills

Leadership

Presentation skills

Data-driven decision making

Communication

Education

Doctor of Pharmacy (PharmD)

Bachelor of Science in Pharmacy

Job description

# Director, Specialty Clinical Solutions: Home: Oct 7, 2026: Oct 7, 2026## About the roleAt 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 TitleDirector, Specialty Clinical Solutions- REMOTEJob DescriptionThe 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 assignedMinimum 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 sponsorshipAdditional 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 productionPreferred 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 businessEvery 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 proceduresEvery 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 $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 (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.