Clinical Program Senior Advisor - Centene Medicare

Job Description Summary

Provides counsel and advice to top management on significant Clinical Program Management matters, often requiring coordination between multiple departments. Focuses on providing thought leadership and technical expertise across multiple disciplines. Recognized internally as “the go-to person” for the most complex Clinical Program Management assignments. Represents company externally and serves as conduit to educate Centene. Serves as a trusted partner to the sales organization, providing ongoing operational expertise that positively influence cost, quality, and member satisfaction.

Essential Functions

• Responsible for the successful implementation of new client clinical programs, complete understanding of Express Script’s clinical operations portfolio
• Work directly with client as needed for gathering of requirements and support of clinical benefit changes.
• Identify and document client requirements and complete clinical portion of installation project plans.
• Act as a subject matter expert (SME) in areas relevant to the team.
• Develop strategic relationships/matrix with Clinical Operations and other Express Scripts leaders.
• Leads, coaches, and develops by providing mentorship to members within the team.
• Acts as a strategic business partner to various stakeholders both internal/external.
• Lead and execute large strategic projects designed to enhance operating effectiveness and drive overall change.
• Identify business improvement opportunities using data, feedback, and analysis.
• Execute and deliver processes with a forward-thinking ability to present solutions and identify efficiencies.
• Participates and contributes formal and informal training programs and professional development activities which may include taking, developing, and/or conducting sessions.
• Serve as business owner to necessary client work that involve operational and implementation benefits changes.
• Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications.
• Accurately capture and document clinical benefit requirements in collaboration with business stakeholders
• Provide excellent customer service and act as a trusted client advisor.
• Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood and communicated as necessary.
• Provide operational Subject Matter Expertise (SME) to Clinical Account Executives/Implementation Manager (CAE/IPM’s), Client Benefit Administrators (CBA), Clinical Application Teams (DCRS, FRS, CRS, Criteria), Product Owners
• Manages and tracks all requests to ensure timelines are met.
• Develop a deep understanding of claims adjudication system and associated clinical applications.
• Leads the development, preparation, and presentation of project plan including execution and delivery for each client(s) assigned.

Skills

• Ability to work with cross functional committees or workgroups.
• Able to manage multiple tasks and prioritization; able to function under stressful situations.
• Must have strong commitment to clinical services and company goals.
• Microsoft office with a strong understanding of Excel and Access
• Written and verbal communication (listening, feedback; translating complex ideas/processes), collaboration, analytical thinking/critical thinking, results-oriented and organizational skills.
• Must have the ability to resolve complex issues and have strong project management skills.
• Ability to learn multiple internal reporting and analytic tools for client management.
• Provide project and administrative support to the team and escalate issues, risks, concerns as needed.

Education and Qualifications

• Current U.S. Pharmacist License, Pharm.D.
• 3-5 years pharmacy experience; 3+ years in managed care, the Pharmacy Benefit Manger (PBM) industry, or pharmaceutical sales preferred.
• Proven leadership skills, team-orientation, a proactive management style and strong commitment to client service a must
• Knowledge of PBM industry/Managed care/Value Based healthcare industry is desirable.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 116,200 - 193,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.