Dir, Clinical Operations

Middletown RI 02842

Job Description

Leads the implementation, execution and delivery of clinical programs for health plan clients including MRx departments (MedD PDP, Magellan Methods, Specialty Pharmacy Distribution, etc.) in accordance with best practices. Assists with development, enhancement, and maintenance of operational functions, systems, procedures and clinical support and provider education. Implements and monitors clinical program requirements and timelines, ensures all necessary support, staffing, tools and technology are available, and follows up as needed. Meets with Clinical program managers and other appropriate staff to identify project goals, objectives, critical success factors, and success measures including supporting the company in achievement of revenue goals. Supports other functions as requested throughout the program delivery lifecycle including finance, outcomes, communications and IT.
  • Works closely with 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 contract clinical and operational functions.
  • Oversees and coordinates implementation of new clinical programs and serves as liaison between the Clinical program managers and Clinical Services Center (CSC) outreach team.  Assists in modifying implementation approaches within operational execution of the clinical program. Develops strong relationships and contacts within the company that support the achievement of efficient and effective clinical program outcomes.
  • Through CSC managers, communicates frequently with Clinical program managers to report program progress, establish priorities and maintain positive program outreach results. Responds to requests for information.  Assesses, investigates and resolves difficult issues to achieve program objectives.
  • Coordinates outreach with physicians and prescribers identified as needing consultation to provide coaching on prescriptions and prescribing practices that have been identified as outliers.  Responsible for oversight of all program outreach and delivery.
  • Collaborates with Clinical program managers on development and refinement of consultation scripting used for program outreach.
  • Contributes to the success of the operations of the pharmacy program by assisting with management of both written and verbal communications to physicians and prescribers and maintenance of the edits and data elements that support the edits.
  • Contributes to program execution and delivery by using staff productivity metrics and continuous quality improvement processes within the CSC. Identify improvement opportunities by on-going consultation and collaboration with CSC managers and Clinical program managers.
  • Directs, develops and managers CSC managers and all pharmacist, pharmacy technician, registered nurse, and customer care associates within the CSC. Develops, implements and monitors clinical program delivery working with the clinical team and external customers to execute strategic clinical vision.  Supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns and consulting with physicians regarding these patterns using evidence-based best practices. 


General Job Information


Dir, Clinical Operations



Job Family

Pharmacy Group


United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date


Date Requisition Created


Minimum Qualifications


PharmD: Pharmacy (Required)

License and Certifications - Required

PharmD - Doctor Of Pharmacy, State Licensure - Pharmacy

License and Certifications - Preferred

Other Job Requirements


  • Pharmacy Benefits Management (PBM) experience required.
  • Strong drug product and clinical pharmacy knowledge.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

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