Senior Manager, Clinical Consulting & Plan Performance

About this role

ABOUT THE ROLE:

The Senior Manager of Pharmacy Clinical Consulting and Plan Performance is responsible for managing clinical consulting services and improving the performance of partner plans. This role will work closely with internal teams and external stakeholders to drive initiatives that enhance clinical outcomes, cost efficiency, and overall plan performance. As a subject matter expert (SME), the Manager will provide clinical guidance and collaborate across departments to meet client goals.

WHAT YOU’LL DO:

• Leadership and Strategy:

• Support the development and implementation of strategies to ensure client plan performance commitments are met.

• Act as a clinical SME to the client services team, providing operational guidance and day-to-day management support.

• Collaborate with internal leaders to align clinical consulting efforts with organizational goals.

• Clinical Consulting Services:

• Deliver high-quality clinical consulting services to clients, ensuring evidence-based recommendations.

• Assist in the development and implementation of clinical programs to improve patient outcomes and support client strategies.

• Support clinical discussions with clients during sales, implementations, and ongoing operations including how benefit designs and clinical programs impact financial performance.

• Plan Performance Optimization:

• Analyze pharmacy benefit plan performance metrics to identify trends and areas for improvement.

• Collaborate with internal teams to identify and execute performance improvement strategies and report on outcomes.

• Provide day-to-day support and guidance to the client services team in managing client relationships and performance.

• Stakeholder Collaboration:

• Build and maintain effective relationships with clients, internal teams, and external stakeholders.

• Serve as a resource to the client services team in discussing clinical strategies and performance improvements with clients.

• Participate in client meetings, presentations, and consultations to support ongoing client engagement.

• Act as a liaison between clients and internal teams, ensuring clear communication and alignment on goals.

• Compliance and Quality Assurance:

• Support quality assurance efforts to ensure the accuracy and effectiveness of clinical consulting services.

• Stay updated on industry trends and best practices in pharmacy, PBM, and healthcare, ensuring continuous improvement.

WHO YOU ARE:

• PharmD or equivalent degree from an accredited institution.

• Active pharmacist license in good standing.

• Minimum of 7 years of experience in PBM, health plan, pharmacy clinical consulting, or a related field.

• Proven ability to manage projects and collaborate effectively with cross-functional teams.

• Strong analytical skills with the ability to interpret data and develop actionable insights.

• Excellent communication and interpersonal skills, with the ability to build relationships with clients and internal stakeholders.

• In-depth knowledge of pharmacy benefit management and clinical pharmacy practices.

PREFERRED QUALIFICATIONS:

• Experience with project management and process improvement methodologies.

• Managed Care Pharmacy Residency, MBA, MPH, or a related advanced degree is a plus.

• Previous experience working with health plans or PBMs is preferred.

WORKING CONDITIONS:

• Remote-based with occasional travel for client meetings, conferences, and professional development.

COMPENSATION: $130,000 - $150,000 annually, in addition to bonus and equity

Compensation offered will be determined by geographic location, experience, and qualifications.
CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment.

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for…