Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary:  The Clinical Program Manager (CPM) will have a solid working knowledge of Medicaid program pharmacy coverage and payment rules and possess relevant experience in managing accounts and clinical projects. This pharmacist will attend onsite meetings at the state office building upon Client’s request and maintain responsibility for managing all aspects of the preferred drug list and supplemental rebate administration.

In addition to account/contract management responsibilities, this position also works to optimize the clinical quality and cost-effectiveness of drug therapy for a state Medicaid agency and their members. The focus is on rational management of drug utilization by employing analytical tools and an evidence-based approach to achieve lower net cost, better health outcomes, and high levels of satisfaction for plan sponsors and their members. The position works within corporate resources to achieve overall account and company financial goals. Relies on data and performance indicators, as well as experience and judgment, to identify and promote performance improvement opportunities which attain the aligned goals of MedImpact and the client.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Oversight of all contract requirements, including but not limited to all services, deliverables, and oversight of both internal and subcontractor operations. This includes oversight of preferred drug list (PDL) development, maintenance and drug manufacturer invoicing team and rate-setting team.

• Serve as main point of contact for the account. Works with and oversees a diverse set of professional staff to fulfill contract requirements, including oversight of any subcontracts and their performance.

• Provides recommendations to assigned clients that align with the clients’ goals of lower net costs and high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, P&T support and participation, recommendations for rational drug PDL positioning, on-line system edits and restrictions, on-going clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends.

• Provides clinical and Medicaid consultative services in accordance with contracted clinical and consultative services. Acts as an integral part of designing, developing, and driving the clinical components of assigned account team’s strategic and financial goals. The CPM’s focus will be centered on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously improve the plan sponsor’s quality-focused and financial performance metrics.

• Identifies and promotes MedImpact’s evidence-based interventions and communication programs to clients. Provides documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g. rebate enhancement, lower net cost, generic programs, QA programs).

• Recommends clinically appropriate PDL changes by while considering the lowest net cost after rebates, market shifts and utilization.

• Coordinates clinical utilization analyses and presentations to clients. Ensures timely and accurate review of plan data, according to policy, with appropriate intervention recommendations.

• Coordinates clinical support of Preferred Drug Lists during plan sponsor’s implementation.

• Participates in quarterly state P&T meetings as per client contract. 

Supervisory Responsibilities                                             

This job has no supervisory responsibilities.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; Respond promptly to client needs; solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations. Experience managing or participating in large projects is highly preferred.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience  

Doctor of Pharmacy (or equivalent combination of education and experience).  Must have 5+ years’ related experience.  Medicaid experience preferred.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Office Suite and a working knowledge of relational databases.

Certificates, Licenses, Registrations

Registered Pharmacist in the State of Mississippi.  If licensure is in an equivalent state, must have the ability to obtain a MS license within 6 months of the start of employment.

Other Skills and Abilities

• Account management or comparable experience (required)
• Analytical skills with Health Informatics experience (preferred).
• Experience in promoting drug cost management programs (preferred).

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills

Candidates must have an understanding of pharmaceutical calculations including fractions, decimals, ratios, proportions, percentages, and medication dosing.  In addition, candidates must have the ability to calculate and/or interpret market shares and graphs.

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, policies and procedures, and business correspondence. Ability to effectively present information and respond to questions from groups of managers, clients, and customers.

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

• Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data.

• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.

• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.

• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

• Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or listen. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 35 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required.  Work hours may be changed from time to time to meet the needs of the business.  Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires approximately 25% domestic travel and may require international travel in which case a valid passport and ability to leave the United States will be required.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.