Clinical Services Manager
Company: National CooperativeRx
Location: Madison
Posted on: January 5, 2026
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Job Description:
Job Description Company Description Headquartered in Madison,
Wisconsin, National CooperativeRx is a not-for-profit, member-owned
cooperative that provides cost-effective pharmacy benefit
management to self-insured employers and other purchasers of
pharmacy benefits. The Cooperative leverages collective purchasing
power to access the best discounts and clinical programs from a
pharmacy benefit manager chosen through a competitive bid process.
The focus is on high-quality services with honest, transparent
pricing. Role Description National CooperativeRx seeks a clinical
services manager to join our innovative, dynamic, nationwide
organization dedicated to helping members control pharmaceutical
costs. As a clinical services manager, you will utilize clinical
and analytical skills to positively impact the health of members
while helping reduce health care costs. This position reports to
the Director of Clinical Services. This position is based in
Madison, Wisconsin. The ideal candidate will have: Graduated from
an accredited College or School of Pharmacy with a baccalaureate.
degree in pharmacy and/or a Doctor of Pharmacy degree. Strong
analytical skills with the ability to present and defend findings.
General but functional understanding of a pharmacy benefits
manager, employer self-funding and employee benefits. Strong verbal
and written communication skills. Ability to solve problems
independently and as part of a team. Valid pharmacy license. Duties
include (but are not limited to): Majority of time spent reviewing
prior authorizations (PA) and appeals for specialty medication
prescriptions. Collaborate with internal and external colleagues on
complex cases and conduct peer-to-peer reviews on escalated cases.
Provide other clinical services including high dollar claims review
for members of the Cooperative. Evaluate, recommend, and monitor
PBM clinical criteria. Assist in the creation and implementation of
new or updated Cooperative clinical programs. Evaluate and monitor
PBM utilization reports and develop internal Cooperative reports as
needed. Provide updates to Cooperative staff on drug utilization
patterns and trends. Serve as a clinical resource for health plan
participants, Cooperative members, and other stakeholders on
clinical initiatives and issues. Assist with studies to evaluate
clinical programs Assist with development of a variety of
Cooperative communication materials, including
marketing/educational support materials, newsletter and website
content. Research current medical literature and other references
as necessary to support Cooperative clinical programs and remain
knowledgeable on clinical treatment guidelines and the drug product
pipeline. Interested candidates should send a cover letter, resume,
and compensation requirements to
careers@nationalcooperativerx.com.
Keywords: National CooperativeRx, Huntsville , Clinical Services Manager, Healthcare , Madison, Alabama
