Georgia Medicaid Clinical Account Manager

Georgia Medicaid Clinical Account Manager - RemoteAt Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.Innovative business clinician accountable for building and maintaining customer relationships as well as leadership of the account teams within all assigned accounts. Charged with delivering results that demonstrate value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract compliance.Accountable for developing and executing the strategic plan for their accounts in conjunction with sales and operations.Responsibilities Performs customer centric pharmacy services. Owns overall account satisfaction for all assigned accounts. Develops strong relationships with pharmacy department or designated customer contacts. Directs operations account manager in resolving customer service issues and actions supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense. Maintains knowledge in all aspects of the contracts with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment. Creates and maintains partnerships with customers through the development, implementation and execution of strategic business plans that result in long term retention of profitable relationships. Ensures all Customer and Account-Facing services are provided in a consistent and timely fashion. Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). Identifies opportunities for additional services that address unmet customer needs. Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and programs and provides support to client-specific Pharmacy and Therapeutics functions, DUR committees and responsibilities. Supports elevated customer service and prior authorization inquiries specific to assigned accounts. Manages financial aspects of account(s). Ensures revenue goals are met, cost of care and administrative expenses managed, and EBIDTA targets achieved for the assigned account(s). Ensures contract performance through risk management activities including such items as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment. Develops opportunities: Seeks and identifies pharmacy products and service requirements based on a thorough understanding of each customer's strategic business goals and the strategic business direction of the product set. Aggressively drives up-sell of pharmacy program solutions through consultative methods and ensures flawless handoff to sales and relationship management for contract execution. Supports sales and account management in renewal activities related to assigned accounts. Manages talent: Accountable for identifying creative talent to serve the account, as well as retention of high performing team members. Ensures staff is trained and receive opportunities to learn new things.Minimum Qualifications Bachelors - Pharmacy 2+ years of Management Leadership 5+ years of Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorshipAdditional Qualifications 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency. Proven ability to plan, organize, schedule, direct, control and monitor project activities. Well-developed interpersonal skills. Able to perform basic financial analysis. Project management experience and knowledge of health plans required. Provider experience preferred.Preferred Qualifications Masters' Degree PharmD - Doctor Of Pharmacy, State Licensure - PharmacyEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays.If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.