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.
The Account Manager Pharmacist / Clinical Consultant will lead and manage ongoing contract relationships and 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 serves as the primary liaison between OptumRx clinical operations, professional practice, and clinical products and 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.
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To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
If you are located in Central or Eastern Time Zone, you will have the flexibility to work remotely * as you take on some tough challenges. Hours will be 8am-5pm EST.
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 and NCQA measures
- Provides superior clinical consultation and clinical account management with a focus on client satisfaction, client retention, and trend management
- Stays aware of and provides clinical market intelligence to clients
- Communicates drug information to clients and responds to plan - specific clinical inquiries
- Formulates and delivers client recommendations based on available data
- Makes clinically sound recommendations to clients based on trend
- Identifies and creates opportunities to manage trend and add OptumRx products
- Demonstrated ability to incorporate treatment and practice guidelines into client presentations including upselling opportunities
- Identifies opportunities for clinical program upsell
- Effectively manages client objections to new programs and required changes
- Clearly communicates analytical and reporting needs to supporting departments
- Researching new prescription drugs or new applications of existing drugs and assist in the development of drug use guidelines.
- Participating in cost and benefit analyses of prescription drugs to support development of Preferred Drug Lists.
- Developing comprehensive clinical programs with the goal of driving measurable results to improve health outcomes in patient medication self-management, medical cost-savings through compliance and adherence, and collaborating with other health care professionals in their roles for health outcomes
- Internally represents customers and coordinates with other OptumRx business functions to implement customer requests, complete projects, and address ongoing clinical service needs
- Manages / Facilitates custom P&T committees for select clients
- Analyzes and interprets benefit designs
- Facilitates ongoing maintenance of client custom formulary and utilization management updates
- Helps clients be competitive within their market
- Identifies opportunities to increase efficiency
- Mentors clinical coordinators, as needed
Clinical Strategy responsibilities for a complex Health Plan client:
- Staying apprised of potential and future medications through participation in our Pipeline Forecast activities to develop the client-specific quarterly Pipeline Grid Review and Management
- Serves as the Quarterly Performance Review lead on Clinical Consulting team. This includes creation of slide deck, review of data, and collaboration with Account Management and Clinical Analytic Consulting
- Manage client weekly Clinical Strategy Meeting and all associated tasks. This includes promptly responding to client inquiries and closely tracking requests, recurring reporting, Pharma outreach, reporting, and rebate model delivery
- Serves as support to Medicare Part D Clinical Consultant during times of need or staffing changes
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's degree in Pharmacy or Pharm D
- Current and unrestricted Pharmacist license
- 3+ years of client facing, clinical account management experience OR health plan PBM management experience
- Experience working for a PBM and / or Health Plan in a client-facing role with external clients (beyond patients and prescribers)
- Experience developing and delivering formal presentations for external clients
- Proficient skills in Microsoft Office, Power Point, Excel, Word, Teams, OneNote, and Outlook
- Primary residence in Central or Eastern Time zone and ability to work Monday-Friday 8am-5pm EST
Preferred Qualifications:
- Clinical account management experience
- Experience working with complex Health Plan clients with complex benefit structures
- Medicare experience
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The salary range for this role is $89,800 to $176,700 annually based on full-time employment. 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.