Provider Liaison Pharmacist, Trend and Cost Management – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

This role will help support the identification and development of strategies to control trend for a specific grouping of customers that have a pharmacy trend guarantee. This role will independently engage community based physicians and medical group administrators in an educational capacity to identify opportunities to improve formulary adherence and movement to clinically appropriate, lower cost alternatives for clients that have a pharmacy trend guarantee.

 

As part of their daily responsibilities, this individual will work under the guidance and direction of the account teams and Clinical Consultant Pharmacists who are responsible for the overall management of these clients to successfully drive trend mitigation initiatives. This individual will be expected to proactively establish and manage prescriber relationships as an outward facing, dedicated resource.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
 

Primary Responsibilities:

• Plan weekly activities, summarize outcomes and detail actionable items from activities
• Engage top prescribers through face-to-face visits, telephonic outreach, and fax/mail intervention to provide them with key feedback on their prescribing patterns, including benchmarks against relevant peer groups
• Review prescriber-specific opportunities to improve care on behalf of members
• Review patient-specific opportunities to optimize and provide cost-effective, quality care
• Apply marketing/consultation techniques in promotion of national practice guidelines for clinical effectiveness and safety
• Participate in the development of reports providing comparative data on prescribing practices
• Participate in the development of outcome reports to track the success of interventions
• Analyze data to track and trend program impact and identify areas of opportunity to improve the program
• Function with high level of urgency in all business responses- internal and external
• Provide regular progress updates to internal stake holders
• Provide annual presentation of each year’s activities and outcomes
• Assist with providing data and feedback to truly change provider behavior and achieve results
• Build collaborative and trusting relationships with the providers. Work as a clinical liaison between PBM and portfolio of practices/providers
• Maintain confidentiality and use only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities. This position may require PHI or other confidential information be taken outside the office or accessed from home electronically. This individual is responsible for safeguarding this information in accordance with all HIPAA policies and regulations

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelor of Science in Pharmacy or PharmD 
• Current and unrestricted Pharmacist license
• 3+ years of experience as a practicing Pharmacist 
• 1+ years of experience analyzing and interpreting pharmacy claims data, cost drivers and trends 
• Experience in a provider-facing or client-facing role within a PBM or Managed Care (beyond patient-facing)
• Understanding of pay-for-performance programs, ACOs and other performance/quality based initiatives
• Solid clinical knowledge and experience collaborating with providers to recommend or promote clinically appropriate and cost-effective care 
• Experience proactively outreaching to providers or provider offices on pharmacy recommendations and topics
• Experience giving formal presentations
• Proficient skills in Microsoft Office and Outlook
• Ability to travel up to 20% 

 

Preferred Qualifications:

• Completion of an ASHP-accredited pharmacy residency in one of the following: managed care, ambulatory care or specialty pharmacy 
• Experience driving change through collaboration with providers and their staff
• General pharmacy/PBM, medical practices business understanding related to prescribing 
• Understanding of clinical quality programs (i.e. CMS STAR Ratings, NCQA/HEDIS, PQA)
• Academic Detailing experience

 

Competencies:

• Demonstrated record of being a self-starter, with a strong independent work drive
• Habitual use of metrics in daily work
• Effective communication skills (phone, email, written communication and documentation)
• Effective organizational skills
• Effective interpersonal skills, ability to establish and build new relationships

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.