Clinical Director (Payer-Focused Consulting)
Advantage Point Solutions (APS)
WorldwideFully remoteFull TimeHealthcare & Telemedicine
No salary statedPosted 24 days ago3w ago
Why we think you can apply
- Hiring model
- Open worldwide · the employer states no country restriction
- Work from
- Anywhere, the UAE included
Posted 24 days ago
About the role
Responsibilities
- Provide expert opinions to APS and its clients regarding the clinical value of drugs to payers
- Support APS and its clients with broad-based drug information expertise across all therapeutic areas
- Conduct drug information research to understand how payer lines of business perceive and manage new drugs
- Serve as a resource regarding rationales and approaches used by payers for Prior Authorizations and step-therapy edits
- Prepare documents and presentations describing commercial viability and payer coverage management practices
- Plan, conduct, and summarize payer research
- Help to plan, develop, and moderate payer advisory boards
- Review and improve client value proposition presentations, including preapproval information exchange (PIE) presentations
- Interact with current and prospective clients to demonstrate deep drug therapy knowledge
- Assist in the preparation of statements of work (SOW) and participate in client presentations
- Keep current with marketplace trends related to clinical use of drugs and payer formulary management
- Collaborate with APS leadership to achieve company and client objectives
Requirements
- PharmD degree or equivalent (e.g., BS pharmacy with advanced degree)
- 5 to 10 years of experience in a managerial/supervisory drug information position with a payer (health plan or PBM)
- Comprehensive understanding of current payer organizations and the regulatory landscape in Commercial and Medicare
- Experience with payers in developing drug monographs, class reviews, drug formularies, coverage criteria, and clinical policies
- Experience with Commercial and Medicare lines of business (Medicaid experience is desirable)
- Experience in benefit design, coverage determination, and appeal processes
- Experience in P&T committee processes
- Excellent written and verbal communication skills
- Ability to facilitate/moderate virtual or in-person payer advisory boards
- Excellent time management skills and ability to meet deadlines
What we look for
- PharmD degree or equivalent
- 5-10 years experience in managerial drug information position with a payer
- Comprehensive understanding of payer regulatory landscape
- Experience with drug monographs and formularies
- Experience in benefit design and coverage determination
- Experience in P&T committee processes
- Excellent communication skills
PharmacotherapyPBMFormulary ManagementClinical Consulting
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Advantage Point Solutions (APS)
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