Account Executive, Clinical

About The Role

The Clinical Account Executive (CAE) is a vital member of our team, responsible for supporting pharmacy benefit management programs through the development and implementation of advanced clinical strategies. This role involves collaborating closely with clients and internal teams to optimize formulary development, utilization management, and clinical program initiatives. The CAE will serve as a clinical expert, providing insights and recommendations based on comprehensive analysis of pharmacy data. The position requires a proactive approach to client engagement, ensuring satisfaction and fostering long-term relationships.

This is a remote position, offering flexibility and the opportunity to work with a dynamic, multidisciplinary team across various regions.

Qualifications

• Doctor of Pharmacy (PharmD) degree from an accredited college or university; B.S. Pharmacy accepted
• Minimum of five (5) years of pharmacy experience working within a Health Plan or Pharmacy Benefit Manager (PBM) setting
• Experience in client-facing roles with demonstrated ability to deliver presentations and manage client relationships
• Proficiency in utilization management, including specialty medication strategies, clinical program development, drug use evaluation, and formulary management
• Strong analytical skills with the ability to interpret prescription claims data and generate actionable insights
• Excellent written and verbal communication skills, capable of translating complex clinical information for diverse audiences
• Experience with pharmacy data analysis, reporting, and creating ad-hoc reports
• Proficiency in database management systems and Microsoft Office Suite
• Ability to work independently with minimal supervision and support cross-functional teams effectively
• Knowledge of HIPAA regulations and commitment to maintaining patient confidentiality

Responsibilities

• Develop and oversee clinical strategies, including formulary development and utilization management programs, both internally and through third-party collaborations
• Analyze prescription claims data to develop written clinical recommendations and support decision-making processes
• Participate in client implementation meetings, providing clinical expertise and strategic guidance
• Build and maintain strong client relationships to ensure needs are met and satisfaction levels are high
• Collaborate with account management teams to support client needs, including developing clinical recommendations to improve healthcare outcomes and manage drug expenditures
• Investigate and resolve client issues promptly and effectively
• Proactively advise clients on emerging drug pipeline activities and clinical trends
• Conduct meetings with clients to review pharmacy data, discuss clinical trends, and provide evidence-based recommendations
• Serve as the clinical expert on the account team, providing drug information and clinical consultation
• Support operational teams with clinically related program development and implementation
• Create and analyze reports based on pharmacy data, including ad-hoc reporting as needed
• Develop communication materials for internal and external stakeholders regarding formulary changes, medication adherence, and pharmacy trends
• Assist customer service when clinical claim review is required
• Collaborate across departments to align goals, support initiatives, and build consensus
• Perform additional duties and projects as assigned, adapting to evolving organizational needs
• Ensure compliance with HIPAA regulations and report any violations immediately
• Complete all required HIPAA training and demonstrate competency
• Maintain flexibility to adapt responsibilities as necessary in a dynamic work environment