KPP/CLINICAL ACCOUNT MANAGER

Kroger Health & Wellness; Cincinnati (OH); On-site; USD 80,000 - 110,000; Full time

Job summary

An established industry player in health and wellness is seeking a dedicated professional to manage and innovate Kroger Prescription Plans. This role involves developing clinical strategies to optimize pharmaceutical spending while ensuring compliance with industry standards. You will leverage your expertise in pharmacy and healthcare data analysis to enhance client outcomes and drive program success. Join a forward-thinking team that values integrity, diversity, and collaboration, and make a significant impact in the healthcare landscape. If you're passionate about improving health outcomes and thrive in a dynamic environment, this opportunity is perfect for you.

Qualifications

• 5+ years of pharmacy experience in health plans or pharmacy chains.
• 3+ years analyzing healthcare data for informed decision-making.

Responsibilities

• Manage Kroger Prescription Plans and clinical strategies.
• Analyze pharmacy data to improve outcomes and control costs.

Skills

Healthcare Data Analysis

Project Management

Clinical Strategy Development

Communication Skills

Relationship Building

Pharmacy Knowledge

Multitasking

Attention to Detail

Education

Doctorate Degree in Pharmacy (PharmD)

Pharmacist License

Job description

Responsible for establishing new and managing existing Kroger Prescription Plans (KPP) benefit programs by focusing on effective management of all pharmaceuticals, including specialty products. Develop and manage industry-leading, highly managed clinical strategies and innovative programs to drive lower average drug spend for KPP clients. Support all formulary and clinical functions in accordance with established policies and practices. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.

Minimum Qualifications

1. Doctorate Degree in Pharmacy, PharmD
2. Any project management experience
3. 3+ years of experience in analyzing healthcare data
4. 5+ years of pharmacy experience working for a leading health plan, pharmacy chain, or PBM
5. Pharmacist License
6. Extensive knowledge of pharmacy programs and services, specialty medications, formulary development, valuation, maintenance, and contracting processes
7. Ability to prioritize and multitask while providing accurate and on-time results
8. Ability to work both independently and as part of a team
9. Exceptional clinical, business, and relationship-building skills with sound clinical judgment
10. Excellent administrative, communication, and organizational skills with high attention to detail
11. Ability to translate information appropriately for clinical and non-clinical audiences

Desired Qualifications

1. Managed care experience
2. PharmD experience within a clinical practice
3. Develop and implement new clinical strategies and programs, oversee clinical programs and outcomes
4. Meet with clients to discuss clinical trends and provide recommendations
5. Support growth of pharmacy products and develop clinical management playbooks and training platforms
6. Gather information to make informed decisions based on pharmacy and healthcare trends
7. Act as a clinical and drug information SME on the account team
8. Analyze pharmacy data, develop reports, presentations, and recommendations to improve outcomes and control costs
9. Collaborate with work groups to ensure quality of care, cost control, and policy compliance
10. Perform prior authorization and appeal functions, including criteria development
11. Serve as a preceptor for APPE students
12. Analyze impact reports to adapt to formulary and adjudication changes
13. Provide clinical consultation and support services to KPP customers
14. Stay current with PBM industry trends and maintain competitive knowledge
15. Respond to information requests and develop proposals for prospective clients
16. Support operations or projects to meet workflow, schedule, and quality requirements
17. Travel to meet with clients and various enterprise units
18. Must be able to perform essential job functions with or without reasonable accommodation