Remote Director, Specialty Clinical Solutions

Prime Therapeutics; Annapolis (MD); Remote; USD 143,000 - 243,000; Full time

Job summary

Prime Therapeutics is seeking a Director, Specialty Clinical Solutions to lead clinical services and strategies within medical pharmacy and specialty programs for clients. The role oversees utilization management, analytics, program design, regulatory compliance, and client-facing materials.

A PharmD or BS Pharmacy and 7+ years of experience are required. This remote role supports client success across the health plan landscape, with responsibilities spanning strategy, thought leadership, and

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree.
• 7 years of work experience in medical pharmacy or 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 visa sponsorship.
• 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 production.
• 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 business.

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.
• Collaborate 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 assigned

Skills

Interpersonal skills

Communication

Verbal communication

Written communication

Presentation skills

Organizational skills

Consultation

Education

PharmD or BS Pharmacy

Job description

Prime Therapeutics is seeking a Director, Specialty Clinical Solutions to lead clinical services and strategies within medical pharmacy and specialty programs for clients. The role oversees utilization management, analytics, program design, regulatory compliance, and client-facing materials.

A PharmD or BS Pharmacy and 7+ years of experience are required. This remote role supports client success across the health plan landscape, with responsibilities spanning strategy, thought leadership, and