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.
The Clinical Consultant serves as the primary liaison between OptumRx clinical operations, professional practice, clinical products and the Clinical Consultant's assigned client base. The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments. The Clinical Consultant establishes client relationships and serves as primary point of contact for overall and dayto-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.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. 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 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 where applicable
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)
Incorporate treatment and practice guidelines into client presentations including up-selling opportunities
Comprehend and effectively explain formulary and clinical program changes to clients
Effectively manage client objections to new programs and required changes
Identify and create opportunities to manage trend and add Optum products
Formulate 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 P&T committees for select clients, per contractual requirements
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 of Science in Pharmacy or Doctor of Pharmacy degree
Active, unrestricted, US state-specific pharmacist license
3+ years of pharmacy practice experience or equivalent
Proven basic competency in Microsoft Word, Excel, PowerPoint, Teams and Outlook
Proven ability and willingness to travel
Proven excellent written and oral communication skills
Proven excellent interpersonal skills
Demonstrates solid initiative
Demonstrates high achievement drive
Proven exhibits competent problem-solving skills
Proven solid history of building relationships
Preferred Qualifications:
ASHP-accredited residency in Managed Care
3+ years of managed care or PBM experience
2+ years of client facing or clinical account management experience
Demonstrated strong presentation skills and experience
Demonstrated solid clinical and analytic background
Proven ability to successfully manage multiple clients simultaneously
Competencies and Best Practice for High Performers
Generally, work is self-directed and not prescribed
Ability to works without guidance; seeks guidance on only the most complex tasks
Translates concepts into practice
Works with less structured, more complex issues
Serves as a resource to others
Coach, provides feedback, and guides others
Provides explanations and information to others on difficult issues
Communicates effectively both orally and written Strong communication, presentation, interpersonal, and computer skills
Team player
Ability to translate clinical recommendations to member and client impact
Knowledgeable about drug development pipeline and new generics
Expert on industry best practices
Is up to date and stays updated on treatment and practice guidelines
Thoroughly knowledgeable on clinical program outcomes
Understand client population and disease burden
Is familiar with clinical rules for formulary management and clinical edits
Ability to bring new ideas and creative thinking to multiple business situations
Understands operations and financial terms of contracts (i.e. including clinical performance guarantees, rebate guarantees, and generic dispensing rate guarantees)
Understands financial impacts to client and Catamaran of formulary, benefit and clinical program changes (including rebates, administrative costs and client profitability)
Has detailed knowledge of pricing concepts, terminology, and applications to business situations
Able to analyze & interpret claims data, cost drivers, trends, and patterns
Understands PBM and pricing terminology
Understands book of business trends
Understands implications of making various benefit and clinical program changes
Able to apply understanding of pricing to resolve pricing questions and issues
Able to interpret financial material provided to the account team
Understands fraud, waste & abuse requirements, clinical quality programs and initiatives, and other clinical aspects of the program
Client relationship and customer service mindset
Is highly responsive to internal and client requests, questions, and communications
Is proactive; anticipates client needs and trends
Targets messages to varied audiences based on client experience
*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 $91,700 - $163,700 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.
Optum, part of the UnitedHealth Group family of businesses, 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 h...