Clinical Account Executive - REMOTE

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Full Time Operational Level Minneapolis, MN, US

30+ days ago Requisition

The Clinical Account Executive (CAE) will support pharmacy benefit management programs with the development of industry leading, highly managed clinical strategies including formulary development, utilization management, rules development, vendor management, and development of Liviniti’s Clinical Care Management product. The CAE will also be responsible for client relationships and will work collaboratively with account teams in support of Liviniti's clients in order to improve the quality of care while controlling or decreasing overall health care costs.

• Develop new clinical strategies, as well as provide oversight of clinical programs developed internally and by third parties.
• Analyze, interpret, and develop written recommendations using prescription claims data.
• Participate in client implementation meetings.
• Develop and maintain Client relationships to ensure needs are met and overall satisfaction.
• Work collaboratively with Account Management to support client needs.
• Develop client specific clinical recommendations to improve overall healthcare outcomes and control drug spend.
• Investigate and resolve all client issues.
• Proactively make recommendations for clients to stay ahead of the curve regarding drug pipeline activity.
• Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations/supportive rationale for clinical management strategies.
• Provide drug information as the clinical consultant/expert on the account team.
• Provide operational subject matter expertise to Account Management and Implementation teams for clinically related programs.
• Analyze and evaluate pharmacy data and reporting, as well as create/design ad-hoc reports.
• Develop communication materials to both internal and external parties when necessary regarding formulary and utilization management changes, health literacy, medication adherence, and pharmacy trends.
• Support the customer service department when clinical claim review is needed.
• Effectively collaborate with cross-functional teams to build consensus among all departments while supporting overall goals and initiatives.
• Perform other responsibilities and projects on as needed basis.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
• Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

Our benefits package is designed to keep our employees happy and healthy - physically, mentally and financially.

• Disability and Life insurance
• Employee Assistance Program
• Remote work options
• Generous Paid-Time Off
• Annual Reviews and Development Plans
• Retirement Plan with company match immediately 100% vested

• Ability to work independently.
• Ability to translate clinical information into a manner appropriate for clinical and non-clinical audiences.
• Ability to research and analyze medical literature, including drug information, disease states, and…