Clinical Program Manager, Medication Therapy Management - National 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.

As a Clinical Program Manager, Pharmacist you will lead, maintain, and enhance clinical pharmacy programs. This is your opportunity to join a pharmacy team with a focus on clinical strategy, business impact, and cross-functional collaboration.  You will find an incredible team culture that provides opportunities to learn and evolve every day.

In this role you will also provide leadership in the development and management of clinical programs. You will be empowered to do your best to develop the strategy and vision for product roadmaps, establish collaborative relationships with external and internal stakeholders, gather accurate requirements and evaluate product performance to enhance our mission of helping people live healthier lives.

As a part of the Clinical Programs team, the Clinical Program Manager, Pharmacist is responsible for the strategy, business case presentation, design, development, and launch of new programs, program enhancements, and / or market opportunities that cut across all channels that OptumRx serves. Role will also be responsible for managing the Medication Therapy Management (MTM) program and ensures compliance with CMS MTM programs and satisfaction of clients. Given time - sensitive issues required by CMS and other regulatory bodies, there may be times when extended work hours are required to ensure deliverables are met in a timely manner.

Primary Responsibilities include both pharmacy (15%) and program management (85%)

 Pharmacy:

• Serve as a clinical subject matter expert (SME) for MTM, Part D Stars, and related CMS requirements
• Clinical analysis of outcomes data for yearly reporting
• Present clinical program findings before National Pharmacy & Therapeutics (P&T) committee
• Oversee pharmacy projects from inception to completion
• Research clinical program qualification and outcomes criteria
• Assess and interpret customer needs and requirements
• Identify solutions to non-standard requests and problems
• Coach, provide feedback and guide others, acts as a resource for others with less experience
• Work with other pharmacists and internally to clinical program adoption

Program Management:

• Ability to interpret competitive intelligence, industry and market trends, and customer feedback and devise strategies and plans for product development opportunities
• Adapt at developing sound development business cases and cost / benefit analyses to support product development efforts
• Ability to translate ideas into strategies, define plan for those strategies, and work cross-functionally to launch and execute on product development plans - with defined roadmap with timelines
• Work directly across many departments and cross functional teams to design, develop and drive successful deployment of new and enhanced programs and services
• Support defining business-level requirements for enhancements and net-new capabilities
• Support the development of market and sales strategies and value proposition
• Navigate and influence multiple cross - functional teams in a complex, matrix work environment, which may require working across Optum and UHG business units
• Adapt departmental plans and priorities to address business and operational challenges
• Analyze data and prepare management summaries related to work stream results, performance management, results, audit results, CMS reporting, and client reporting
• Support client-specific strategies, and project plans for metric improvement.
•  Lead client interactions, including presenting program performance, strategy, and recommendations
• Drive program performance against key metrics (e.g., CMR completion, Star Ratings) and identify opportunities for continuous improvement
• Manage timelines, deliverables, and dependencies to support CMS submission requirements and client commitments
• Develop and present executive-level business cases, including PowerPoint presentations and supporting analyses, to senior leadership and clients

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

Required Qualifications

• PharmD or Bachelor's degree in pharmacy 

• Current and unrestricted pharmacist licensure  
• 3+ years of experience working as a clinical pharmacist
• 3+ years of Managed Care experience OR Clinical Program Development/Clinical Program Management experience

• Beginner level of knowledge to navigate and use for analysis: Microsoft Excel proficiently and other MS Office tools with Windows based environment

• Beginner level of knowledge to collect, analyze, and interpret data to develop business strategies and recommendations.   

• Beginner level of knowledge to navigate Outlook and conduct Internet searches

Preferred Qualifications:

• Critical thinking expertise
• Managed Care experience
• Experience with Medication Therapy Management (MTM)
• PBM experience
• Pharmacy residency experience
• Medicare Part D experience
• Experience conducting competitive market intelligence analysis
•  Experience presenting to senior leadership, clients, or external stakeholders
•  Experience with CMS Stars measures and performance strategy
• Master of Business or other advanced business degree

*All Telecommuters 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 $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

#RPO, #GREEN