Executive Remote Rn Data Abstractor Jobs in Orlando, FL

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 Southern Scripts’ Clinical Care Management product. The CAE will also be responsible for client relationships and will work collaboratively with account teams in support of Southern Scripts’ 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.
  1. Develop client specific clinical recommendations to improve overall healthcare outcomes and control drug spend.
  2. Investigate and resolve all client issues.
  3. 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.

• Medical, Dental, Vision insurance
• 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 clinical practice guidelines, and apply sound clinical judgment.
• Support the Clinical, Account Management, and Implementation teams
• Maintain professional image and presence.
• Adhere to all SS policies and procedures.

Supervisory Responsibility

There are no direct supervisory or management responsibilities.

• Full-time/Salaried/Exempt.
• Some flexibility in hours is allowed, but the employee must be available during the “core” work hours of 8:00AM to 5:00PM CT. We cover clients from West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends and holidays pursuant with industry demands.

This position requires up to 10% - 25% travel. Travel is outside the local area and overnight.

• PharmD from an accredited College of Pharmacy; B.S. Pharmacy accepted.
• Five (5) years of pharmacy experience working for a Health Plan or PBM.
• Experience in client-facing role and client presentations.
• Experience with utilization management including specialty medication management strategies, clinical program development, drug use evaluation, and formulary development and maintenance.
• Excellent written and oral skills, both in developing materials and presenting to clients.
• Ability to multi-task and work outside the clinical environment.
• Exceptional clinical, business, and relationship building skills.

• Completion of a pharmacy practice, managed care, or specialty residency.
• Three (3) years of experience in analyzing raw prescription claims data.
• Proficiency in using database information systems and Microsoft Office Suite.

Liviniti, LLC and all entities provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Liviniti expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/V/D