Account Manager Pharmacist Clinical Consultant, Medicaid Fee For Service – Remote in Vermont

Columbus, OH, United States

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 Clinical Consultant serves as the primary liaison between OptumRx clinical operations, professional practice, clinical products and the Clinical Consultant’s assigned Fee-for-Service Medicaid client . The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments. Lead and manage ongoing contract relationships and pharmacy benefit analysis and consultation delivery to Medicaid clients. The Clinical Consultant establishes client relationships and serves as primary point of contact for overall and day-to-day service delivery for clinical pharmacy needs. This individual is relied upon to provide proactive clinical recommendations, information regarding pharmacy trend, clinical programs and products, and industry changes to clients, thereby fostering consultative relationships. This individual also represents client(s) internally and coordinates with other functional areas to implement client initiatives, complete projects, and address ongoing pharmacy service needs.

Location: Waterbury, Vermont

If you are located in Vermont, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Provide superior clinical consultation and clinical account management with a focus on client satisfaction, client retention, and trend management

Collaborate with the client to establish achievable but aggressive clinical program goals, implementation and ongoing management of utilization management programs, improvement in medication adherence rates, improvements in therapy gaps for key chronic disease states, and preferred drug list (PDL) initiatives and support

Communicate drug information to clients and respond to plan-specific clinical inquiries

Stay aware of and provide clinical market intelligence to clients

Identify opportunities for clinical program up-sell and spearhead up-sell to assigned client(s), where contractually appropriate

Incorporate treatment and practice guidelines into client presentations including up-selling opportunities

Comprehend and effectively explain formulary and clinical program changes to clients and internal departments

Effectively manage client objections to new programs and required changes

Identify and create opportunities to manage trend and add Optum products

Formulate and deliver client recommendations based on available data and trend

Deliver clinically sound and fiscally responsible recommendations to clients based on their trend

Routinely collaborate with account management to provide clinical aspects of client quarterly reviews

Analyze & interpret benefit designs

Collaborate in development of strategy as outward facing, dedicated or designated resource for assigned accounts, typically with direct client contact

Bring innovative ideas that can be scaled across the organization

Work in a collaborative manner with the Consultant(s) of assigned client(s) while maintaining focus on UHG and Optum strategies and goals

Clearly communicate analytical and reporting needs to supporting departments

Help clients be competitive within their market

Identify opportunities to increase efficiency

Manages/facilitates custom Pharmacy and Therapeutics (P&T) committees and Drug Utilization Review Board meetings for select clients, per contractual requirements

Prepare meeting material

Present recommendations, provide written analysis and respond to questions from the board members

Review and recommend clinical prior authorization criteria

Formulate, develop and provide to the P&T Committee recommendations for preferred drugs in each reviewed class

Implement changes to the PDL and prior authorization requirements which will include modifications to the POS system and all supporting systems and documents

Serve as the Prior Authorization Call Center Liaison

Provide education for clients, pharmacists, members and physicians per contractual requirements

Support sales and marketing including participating in RFP & Finalist activities, per department policies

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 experience working as a licensed pharmacist

Experience working in a client-facing role with external clients (beyond patients and prescribers)

Fee-for-Service Medicaid experience

Experience developing and delivering formal presentations

Proficient in Microsoft Office and Outlook

Primary residence in the state of Vermont

Willing or ability to travel up to 25%

Preferred Qualifications:

Clinical account management experience

Experience working for a PBM and / or Health Plan in a client-facing role

Experience working with complex public sector and government clients with complex benefit structures

Experience with transition/implementation of clients

Formulary Management experience

DUR experience

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

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.

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