Clincial Consultant

Position Summary: 

The Clinical Consultant is a critical client-facing role within the Enterprise Platform Services division, responsible for providing strategic clinical guidance and managing pharmacy benefit operations for RxSense clients. This position bridges clinical strategy with technology solutions, supporting client formulary initiatives, utilization management, and PBM platform integration. The Clinical Consultant applies deep industry knowledge and experience to drive clinical value, support implementation efforts, and improve client outcomes. This role reports to the Manager of Clinical Consulting.

Essential Duties and Responsibilities:

Client Support and Strategic Consultation

• Serve as a clinical subject matter expert for assigned clients, offering guidance on pharmacy benefit design, formulary strategy, and utilization management protocols.
• Collaborate with the account management and benefits teams to implement and maintain client-specific formularies and UM programs.
• Respond promptly to client inquiries, resolve issues efficiently, and manage difficult or emotional situations with professionalism and empathy.
• Deliver data-driven recommendations based on market trends, formulary performance, and clinical insights.
• Provide training and education to clients on RxSense platform tools.

Formulary Development and Clinical Strategy

• Support the modeling and development of custom client formularies.
• Monitor and assess new drug approvals and market changes to keep client strategies current and compliant.
• Support new business development efforts, including RFP responses and formulary disruptions for prospective clients.
• Maintain awareness of rebate and market access dynamics to support strategic formulary recommendations.
• Participate in internal committees focused on clinical value, drug assessments, and innovation.
• Provide mentorship to team related to P&T preparation, recommendations, and presentation

Operational Excellence and Cross-functional Collaboration

• Execute formulary and utilization management changes per client direction and ensure correct adjudication at point-of-sale.
• Participate in special projects and cross-functional initiatives to enhance clinical services.
• Ensure high-quality deliverables and adherence to timelines across assigned accounts.
• Work closely with internal clinical, benefits, and technology teams to ensure client needs are met and translated effectively into system configurations and workflows.

Education/Experience:

• PharmD or bachelor’s degree in pharmacy required.
• Active and unrestricted pharmacist license (in any U.S. state).
• 1 + years of experience in managed care, PBM, or a clinical pharmacy setting.
• Proven experience in formulary strategy, utilization management, or clinical account support.
• Strong understanding of pharmacy benefit design, clinical program implementation, and adjudication platforms.
• Ability to interpret complex clinical and market data to guide client strategy.
• Excellent verbal and written communication skills; confident presenter.
• Strong customer service orientation with ability to build trust and rapport with clients.
• Effective time management and organizational skills in a fast-paced environment.
• Demonstrated ability to work independently and collaboratively with cross-functional teams.
• Ability to manage multiple priorities and projects in a dynamic, fast-paced environment.
• Intellectual agility and ability to simplify and clearly communicate complex concepts.
• Must be able to develop and maintain strong working relationships on a multi-level basis.
• Willingness and ability to travel 10%.

Salary Range: 125,000 - 145,000