Program Manager, Clinical Account Director

Gainwell Technologies; Missouri; Remote; USD 100,000 - 140,000; Full time

Job summary

Gainwell Technologies seeks a Program Manager, Clinical Account Director to lead operations and ensure customer satisfaction in pharmacy benefit administration. This role demands expertise in managed care, customer relations, and strategic initiative execution. The candidate will work remotely while making a significant impact on healthcare solutions.

Benefits

Flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Leadership and technical development academies

Qualifications

• 5+ years of managed care pharmacy or PBM operations leadership experience required.
• Pharmacy degree and MO licensure highly preferred.
• Strong presentation, negotiation, and communication skills required.

Responsibilities

• Ensure customer satisfaction and build relationships with client leadership.
• Oversee business intelligence across business segments.
• Drive operational model performance and implement strategic initiatives.

Skills

Leadership

Communication

Presentation

Negotiation

Analytical Skills

Education

Bachelor’s degree or equivalent combination of education and experience

Pharmacy degree

Master’s degree in business or healthcare administration

Tools

Microsoft Office Suite

Job description

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Program Manager, Clinical Account Director

Location:

Any city, MO, US, 99999 Any city, MO, US, 99999

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

The primary responsibilities of this position are to ensure customer satisfaction, build and maintain trusting relationships with client leadership, retain clients, escalate and resolve operational issues to meet contract expectations and assure operations are aligned with organizational priorities.

The position manages the relationships between all stakeholders, develops the pharmacy benefit administration (PBA) business, assures appropriate data evaluation and ensures financial viability. This role partners with the market health plan CEO and other internal business partners.

Your role in our mission

· Serve as primary point of contact for the Missouri Single PBA

· Provide leadership throughout the Missouri PBA including strategic and operational oversight to drive operating model performance and implement strategic initiatives

· Ensures contract objectives and service levels are consistently met

· Partner with leadership team and stakeholders to define top areas for selling, general and administrative expenses and cost of service improvements and implement plans to achieve desired savings

· Oversee business intelligence across business segment to include data, analytics, and reporting requirements for new and existing operations

· Makes recommendations for improvements to meet customer expectations.

· Assures quality improvement initiatives are improving the value and cost effectiveness of PBA operations

· Drives utilization and quality in order to maximize overall program effectiveness

· Leads presentations to client and makes routine client visits

· May have direct reports

· Pharmacy degree and MO licensure highly preferred

· Bachelor’s degree or equivalent combination of education and experience required

· Master’s degree in business or healthcare administration preferred

· 5 or more years of managed care pharmacy or PBM operations leadership experience required at the director level

· Experience with end-to-end pharmacy claims lifecycle, clinical operations, call center management, medication pricing methodologies, NCPDP standards, financial management and managed care statute

· Experience evaluating healthcare data/outcomes is required

· Strong presentation, negotiation, and communication skills required

· Demonstrated leadership ability to drive results across the PBA through team influence and collaboration in a matrixed / shared service organizational model required

What we're looking for

· Ability to manage various projects and teams simultaneously

· Demonstrated record of improving operational efficiencies and improving financial performance

· Excellent verbal and written skills

· Understanding of State and Federal regulations; familiarity with the requirements of accrediting organizations

· Capable of interacting with medical specialties staff (MDs, Nurses, Care Coordinators, etc), and Pharmacy Leadership

· Strong acumen with establishing and monitoring clinical and business performance measures

· Strong skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis, and present to senior leadership and staff

What you should expect in this role

Position is remote. Qualified candidate should reside within, MO; exceptions will be considered. Position requires periodic travel.

The pay range for this position is[[salaryMin]]-[[salaryMid]] per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.