Senior Director, Specialty Clinical Solutions - Remote

Prime Therapeutics; Helena (MT); Remote; USD 143,000 - 243,000; Full time

Job summary

Prime Therapeutics, a leading PBM, seeks a Director, Specialty Clinical Solutions – REMOTE. The Senior Director oversees clinical services within Medical Pharmacy & Specialty programs, guiding strategy, utilization management, analytics, and compliance for enterprise clients.

Responsibilities include serving as the clinical SME for clients, partnering with account teams, developing innovative medical pharmacy strategies, evaluating therapies and market trends, and mentoring cross-functional

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree.
• 7 years of work experience in medical pharmacy or at 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 the need for work visa or residency sponsorship.

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

Pharmacist license

Clinical consultation

Education

PharmD or B.S. Pharmacy

Job description

Prime Therapeutics, a leading PBM, seeks a Director, Specialty Clinical Solutions – REMOTE. The Senior Director oversees clinical services within Medical Pharmacy & Specialty programs, guiding strategy, utilization management, analytics, and compliance for enterprise clients.

Responsibilities include serving as the clinical SME for clients, partnering with account teams, developing innovative medical pharmacy strategies, evaluating therapies and market trends, and mentoring cross-functional