Director, Specialty Clinical Solutions

Prime Therapeutics

. Oversee clinical services and strategies within Medical Pharmacy and Specialty programs .

Posted 10/7/2026full-timeRemote • United StatesLead💰 $143,000 - $243,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medical Pharmacy and Specialty programs, with a focus on strategic guidance, clinical solution design, and program enhancements. Proven ability to lead cross-functional teams, develop client-facing materials, and engage in industry initiatives.

Highest-signal resume keywords

Doctor Of Pharmacy (PharmD)Medical Pharmacy ManagementClinical Solution DesignClient-Facing Clinical Materials DevelopmentRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data InterpretationUtilization Management SolutionsFee Schedule ManagementPrior AuthorizationPost-Service Claim Edits

Soft Skills

Interpersonal SkillsCommunication SkillsOrganizational SkillsPresentation SkillsConsultation Skills

Certifications & Qualifications

Current Pharmacist License

Industry Keywords

Medical Benefit Drug ManagementHealth Plan ExperienceEmerging TherapiesMarket TrendsClient Retention

About the role

Key responsibilities & impact

Oversee clinical services and strategies within Medical Pharmacy and Specialty programs
Serve as lead clinical consultant and subject matter expert for assigned clients
Provide strategic guidance on medical pharmacy and specialty programs
Partner with account management and business development teams on client retention, growth opportunities, financial analyses, and new business initiatives
Develop innovative medical pharmacy strategies using data-driven insights, clinical solution design, and program enhancements
Evaluate emerging therapies, market trends, and medical benefit drug management opportunities
Oversee client-facing medical pharmacy programs and utilization management solutions, including fee schedule management, prior authorization, and post-service claim edits
Identify opportunities to expand existing programs and recommend new solutions
Collaborate with cross-functional teams to evaluate program performance, develop business rules, deliver actionable insights, and drive continuous improvement
Lead development of client-facing clinical materials, strategic presentations, thought leadership content, and industry publications
Represent the organization as a clinical expert and mentor through industry engagement, enterprise initiatives, conference presentations, and guidance to peers and cross-functional partners
Perform other duties as assigned

Requirements

What you’ll need

Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree
7 years of work experience in medical pharmacy or at a health plan with multiple lines of business
Current pharmacist license to practice in the applicable state(s)
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Strong interpersonal, communication, consultation, organizational, tracking, and follow-up skills
Ability to research, obtain, coordinate, and integrate feedback from diverse operational groups
Excellent verbal and written communication skills
Strong presentation skills
Preferred: Medical Pharmacy management, strategy, and data interpretation experience at a health plan
Preferred: Health plan experience managing drugs on both the Pharmacy and Medical benefit across all lines of business
Ability to comply with security responsibilities, legal, regulatory, contractual, and internal policy requirements
Ability to perform the essential functions of the job, with reasonable accommodations where applicable

Benefits

Comp & perks

Benefits, incentives, and additional compensation are available through the employer’s Benefits Page
Reasonable accommodations for employees with disabilities
Equal opportunity and affirmative action employment
Tobacco-Free Workplace