Clinical Consultant, Strategic Accounts

Description:

ABOUT TRUDATARX

TruDataRx, Inc. uses objective clinical data to help clients improve the clinical efficacy and reduce the costs of pharmacy benefits for its members. We are independent from all players in the pharmaceutical manufacturing and distribution industries, enabling us to best serve our clients. We value the following characteristics in our team members:

• Outward Mindset – foundation of our culture, which influences the right behaviors, that leads to results
• Entrepreneurial – the ability to get things done with resources you don’t control
• Humility – deep comfort in knowing when you don’t know and asking questions
• Collaboration – we always give benefit of doubt that each person has something to contribute

POSITION SUMMARY:

TruDataRx is seeking a Clinical Consultant, Strategic Accounts to serve as the clinical and strategic lead of our most complex client relationships. This role is responsible for overall client satisfaction via hands-on relationship building, development of client specific strategies, and oversight of the implementation of TruDataRx’s product suite customized to address specific client needs. The ideal candidate possesses deep knowledge of the pharmacy benefits landscape, excels in translating client needs into actionable strategies based on clinical and financial data, and thrives in a collaborative, cross-functional environment.

ESSENTIAL FUNCTIONS

Strategic Account Leadership & Clinical Consultation

• Act as the primary strategic relationship lead and clinical executive for complex accounts, driving clinical strategy, performance, and portfolio growth from implementation through long-term renewal, including identifying expansion and upsell opportunities.
• Direct cross-functional collaboration across clinical, data, and implementation teams to align workflows, meet client-specific objectives, and ensure flawless delivery of services.
• Synthesize complex pharmacy benefit and financial data to construct comprehensive clinical utilization reviews, baseline spend analyses, and performance reports for executive stakeholders.
• Translate complex client requirements into actionable, evidence-based solutions by leveraging proprietary product suites, comparative effectiveness research (CER), and strategic pharmacy benefit designs.

Formulary Operations & Maintenance

• Direct formulary administration operations for assigned accounts, managing routine database updates, implementing decisions from internal clinical committees, and executing custom formulary revisions.
• Advise on tier placement, utilization management (UM) strategies, and benefit design configurations, conducting clinical and financial evaluations to optimize plan cost-containment and therapeutic placement.
• Serve as the principal clinical escalation point to resolve operational database anomalies, ensuring precise synchronization between custom client benefit structures and Pharmacy Benefit Manager (PBM) adjudication platforms.

Prior Authorization & Utilization Management Operations

• Orchestrate the strategic design, continuous refinement, and maintenance of prior authorization (PA) criteria and utilization management (UM) clinical protocols.
• Lead the deployment of custom clinical programs and govern technical override protocols alongside internal cross-functional teams and external partners.
• Evaluate operational metrics, including prior authorization volumes, determination patterns, and claim rejections to continually optimize member and provider experiences.
• Investigate and resolve highly escalated clinical inquiries by diagnosing complex claim denials, identifying appropriate therapeutic alternatives, and executing proactive provider outreach.

Drug Information & Evidence-Based Strategy

• Collaborate with the clinical data team to establish robust guidelines and methodologies for comparative effectiveness research (CER), ensuring appropriate patient population framing and comparator drug selection.
• Utilize data-driven CER methodologies to critically appraise clinical evidence, formulating high-impact strategies that optimize plan efficacy and therapeutic outcomes.
• Perform deep-dive clinical evaluations of volatile, high-expenditure drug classes to analyze expanding indications and forecast long-term plan spend.
• Model and analyze gross-to-net financial scenarios across diverse PBM pricing structures to deliver definitive net savings projections inclusive of complex rebate configurations.

*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.

Requirements:

REQUIREMENTS

• Doctor of Pharmacy or other advanced degree relevant to healthcare/pharmacy benefit operations
• 5+ years of experience in clinical strategy, pharmacy benefits, or health plan account management for clients of varying size and complexity, ideally within PBM, specialty pharmacy or managed care environments.
• Proven success in client-facing roles, particularly in managing complex relationships and delivering customized, strategic healthcare solutions to commercial clients.
• Ability to lead, influence and drive productivity in cross-functional teams, often outside of direct reporting structure.
• Highly communicative and able to synthesize and explain complex clinical and technical concepts cross- functionally.
• Demonstrated expertise in applying comparative effectiveness research (CER) or similar data-driven methodologies to develop strategies and implement programs.
• Ideal candidate has a background either consulting with or providing background clinical oversight directly for a Pharmacy Benefits Manager.
• Ability to travel to onsite client meetings (10%-20%)

Company Standard Requirements:

• Ability to work well with others in a collaborative environment
• Ability to get things done with resources you don’t control
• Willingness to admit you don’t know and ask for help
• Exhibit constant curiosity and a drive to problem solve
• Exhibit desire to learn and grow on a continuous basis