Remote Director, Specialty Medical Pharmacy Solutions

Prime Therapeutics; Lincoln (NE); Remote; USD 143,000 - 243,000; Full time

Job summary

Prime Therapeutics seeks a Director, Specialty Clinical Solutions with medical pharmacy expertise to oversee clinical services and strategies within the Medical Pharmacy & Specialty programs delivered to clients. The role focuses on clinical and utilization management, analysis, innovation, financial management, regulatory compliance, and contractual obligations.

You will lead client-facing teams, develop strategies, evaluate therapies and market trends, oversee prior authorizations and claims

Qualifications

• PharmD or BS in Pharmacy required.
• 7 years of medical pharmacy or health plan experience.
• Current pharmacist license in applicable state(s).

Responsibilities

• Lead clinical consultant for medical pharmacy and specialty programs.
• Support client retention and growth through analyses and new initiatives.
• Develop innovative medical pharmacy strategies using data insights.
• Oversee medical pharmacy programs: fee schedules, prior auth, post-service edits.
• Present clinical materials and industry publications; mentor peers across teams.
• Collaborate with cross-functional teams to improve program performance and reporting.

Skills

Interpersonal skills

Communication

Verbal communication

Written communication

Education

PharmD or BS Pharmacy

Job description

Prime Therapeutics seeks a Director, Specialty Clinical Solutions with medical pharmacy expertise to oversee clinical services and strategies within the Medical Pharmacy & Specialty programs delivered to clients. The role focuses on clinical and utilization management, analysis, innovation, financial management, regulatory compliance, and contractual obligations.

You will lead client-facing teams, develop strategies, evaluate therapies and market trends, oversee prior authorizations and claims