The Clinical Project Manager (PM) position plays a key role in various multi-functional projects critical to Magellan Health Services in achieving its clinical and operational goals and objectives. The Project Manager's responsibility is to develop, implement and monitor clinical specialty programs in the field.
The PM's major responsibility is to serve as clinical liaison for assigned Pharmacy contract(s). Manages overall client relationship. Participates in the development of clinical management products and services.
The PM's activities address impact on customers, operations, program integrity, pricing, quality and satisfaction. The PM develops and tracks the appropriate metrics to monitor the quality and care cost impact of the client's program.
The position requires communication across all departments; an understanding of the strategic impact of the pharmacy programs for the company; knowledge of how the specialty programs integrate with other clinical initiatives and expertise with data management.
Leads the development of clinical program enhancements and better practices. Assist with development, enhancement, and maintenance of operational functions, policy and clinical support and provider education
Develops, implements, and monitors project plan requirements and timelines, ensures all necessary support, tools and technology are available, and follows up as needed. Meets with business process owners and other appropriate personnel to identify the project's goals, objectives, critical success factors, and success measures.
Works closely with CMC teams to ensure consistent delivery of approved programs to their client. Ensures operations are standardized at the fullest extent possible. Provides overall project coordination for the contract's clinical and operational functions.
Oversees/coordinates implementation of new specialty programs and serves as liaison between the company and customers as needed
Assists in modifying implementation approaches within budget and operational framework.
Work jointly with Account Manager to ensure revenue goals, administrative expenses are managed
Develop strong relationships with key contacts at client level.
Develop strong relationships and contacts within Magellan that are supportive of the achievement of increased revenue goals.
Ensure all customers are fully satisfied with MMA services and results
Supports other functions as requested throughout the program development lifecycle including finance, outcomes, communications and IT.
Communicates frequently, either by phone or in person, with client to report program progress, establish priorities and maintain positive client relationship. Responds to client’s requests for information. Assesses, investigates and resolves difficult issues to achieve customer satisfaction
Supports assigned contract for prospective and retrospective drug utilization reviews.
Maintains contract’s Preferred Drug List.
Responsible for oversight of all program reporting. Ensures standard and ad hoc reports are provided accurately and on time.
Supports the State Drug Utilization Review Boards and Pharmacy and Therapeutics Committee.
Field(s) of study: Bachelors in Pharmacy or PharmD Required
Job Specific: 5 years in clinical operations, quality, network, pharmacy or project management. Project management experience and knowledge of health plans required. Provider experience preferred.
Will accept an equivalent combination of experience and education, and education and/or experiences may run concurrent
Other: Able to receive assignments in the form of high level objectives and independently establish detailed goals to meet objectives. Strong interpersonal skills; excellent oral and written communication skills. Ability to function independently and as a team member. Good organization and time management, with the ability to manage multiple tasks. Proven ability to plan, organize, schedule, direct, control and monitor project activities. Well-developed interpersonal skills. Able to perform basic financial analysis. Ability to interact at a high level with external contacts.
Computer Skills: MS Office
Licenses, Certifications, etc.: Current and active Pharmacy License required.
Experience: Strategic planning and disease management experience highly desirable
Work at Home (CO00)
Work at Home
Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.
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