Remote Clinical Account Manager - Payer & Programs

Centene Management Company LLC; Missouri; Hybrid; USD 108,000 - 199,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible remote/hybrid/field schedules

Job summary

Centene is seeking a Clinical Pharmacist to provide clinical expertise in designing benefits and clinical programs to optimize therapeutic outcomes while maintaining economic efficiency in medication therapy. Remote position with approximately 10% travel.

The role involves interfacing with payers, clients, and internal teams to develop and present performance reviews and conduct drug utilization analyses. Ideal candidates will have PharmD/RPh licensure, 3+ years in clinical pharmacy operations

Qualifications

• Bachelor’s degree and licensed qualification in pharmacy (PharmD., RPh).
• 3+ years of experience in Clinical pharmacy operations or case management in specialty pharmacy preferred.
• Direct experience interfacing with payers and/or manufacturers preferred.

Responsibilities

• Provide clinical expertise to clients, explain clinical programs, and communicate new practice or clinical information to clients.
• Develop and present performance reviews in conjunction with client account team.
• Perform clinical data and drug utilization review analysis to meet client requirements and requests.
• Collaborate with Clinical Pharmacists to enhance drug utilization review program and prior authorization review process.
• Provide input into the RFP process and work with Marketing and Sales to facilitate timely response and data analysis.
• Ensure client clinical needs are met, including formulary management and clinical programs.
• Consult with clients to develop and implement appropriate clinical interventions and claim adjudication edits.

Skills

Clinical pharmacy

Payer interfacing

Drug utilization reviews

Formulary management

Education

PharmD./RPh

Bachelor’s degree in pharmacy

Job description

Centene is seeking a Clinical Pharmacist to provide clinical expertise in designing benefits and clinical programs to optimize therapeutic outcomes while maintaining economic efficiency in medication therapy. Remote position with approximately 10% travel.

The role involves interfacing with payers, clients, and internal teams to develop and present performance reviews and conduct drug utilization analyses. Ideal candidates will have PharmD/RPh licensure, 3+ years in clinical pharmacy operations