Clinical Consultant Pharmacist, Health Plans – 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Lead and manage ongoing contract relationships, pharmacy benefit analysis and consultation delivery to clients.  Collaborate in development of strategy as outward-facing, dedicated resources for assigned accounts, typically with direct client contact for large/complex accounts.  Builds client relationships and serves as primary point of contact for overall and day-to-day service delivery for clinical pharmacy needs.  Represents client(s) internally and coordinates with other functions to implement client systems, complete projects, and address ongoing pharmacy service needs.  The Clinical Consultant Pharmacist serves as the primary liaison between OptumRx clinical operations, professional practice, and clinical products for the consultant’s assigned client base.  The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments.  This individual is relied upon to provide proactive clinical recommendations, information regarding pharmacy trend, programs and industry changes to clients and to foster consultative relationships.

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

Primary Responsibilities:

• Collaborates with clients to establish achievable but aggressive clinical program goals, including generic dispensing rate improvements, implementation of utilization management programs, improvement in medication adherence rates, improvements in therapy gaps for key chronic disease states, formulary compliance targets, and HEDIS & NCQA measures
• Provide superior clinical consultation and clinical account management with a focus on client satisfaction, client retention, and trend management
• Comprehends and effectively explains formulary and clinical program changes to clients
• Stays aware of and provides clinical market intelligence to clients
• Provides education for clients, pharmacists, members and physicians per contractual requirements
• Communicates drug information to clients and responds to plan-specific clinical inquiries
• Formulate and deliver client recommendations based on available data
• Identifies opportunities for clinical program up-sell
• Makes clinically sound recommendations to clients based on trend
• Routinely collaborating with account management to provide clinical aspects of client quarterly reviews
• Able to incorporate treatment & practice guidelines into client presentations including up-selling opportunities
• Ability to effectively manage client objections to new programs and required changes
• Manages/facilitates custom P&T committees for select clients
• Able to analyze & interpret benefit designs
• Clearly communicates analytical and reporting needs to supporting departments
• Identifies and creates opportunities to manage trend and add OptumRx products
• Supports sales and marketing including participating in sales activities, as needed based on criteria
• Helps clients be competitive within their market
• Identifies opportunities to increase efficiency
• Mentors clinical coordinators, as needed

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 
• 1+ years of client facing or clinical account management experience OR health plan PBM management experience
• Proficient skills in Microsoft Office and Outlook 

• Ability to travel up to 10%

   

Preferred Qualifications:

• Experience giving formal presentations  
• Medicare experience
• Experience in data analytics and drawing insights 
• Experience in Rx Claim
• Experience in IQPR
• Experience in MediSpan
• Experience in Reporting 360

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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