OptumRX, Dir. Clinical Account Pharmacy (Telecommuter) Job in Atlanta, Georgia US
Primary Responsibilities:
Lead and manage ongoing contract relationships and pharmacy benefit analysis and consultation delivery to clients. Develop strategy and manage team of pharmacists that act 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 pharmacy needs. Represents client(s) internally and coordinates with other functions to implement client systems, complete projects, and address ongoing pharmacy service needs. May work closely with account management and sales on renewals and upselling. Provide information to clients and sales team regarding pharmacy trend, programs and industry changes. Support the clinical pharmacy team with formulary development, clinical program development, appeals processing and other clinical pharmacy functions as the need arises.
Major Responsibilities
- Develop clinical pharmacy account management strategy and process
- Develop strategy for clinical pharmacy account management for business line
- Hire, mentor and manage pharmacist staff
- Provide clinical pharmacy support to national and regional pharmacy sales team to support accounts
- Analyze client trend data
- Run analytical reports to evaluate pharmacy performance for specific clients
- Provide support for pharmacy review meetings
- Support account team to provide information about new and/or existing pharmacy programs
- Work with account team to develop strategic pharmacy plan
- Request for proposal (RFP) support for account management team
- Any other requests made by client or account management team relating to clinical services or programs
- Provide clinical pharmacy support to national and regional pharmacy sales team to support accounts
- Provide support for client meetings as requested
- Provide additional account/client support as requested by the account management team
- Develop and maintain new clinical programs to enhance member health. Support change and innovation
- Identify gaps in member care and help develop pharmacy programs to help close the gaps. Focus on the health outcomes
- Programs may be related to disease state or care management
- Support personal health support (PHS) nurse teams with pharmacy related issues
- Update PHS team about ckunucak program and goals
- Update PHS team about changes in pharmacy benefits
- Support PHS team with clinical pharmacy issues and focusing on increased member compliance and lower member cost for medications
- Training for PHS nurse teams on additional pharmacy issues
- Focus on customer needs
- Provide clinical and analytic support to complete projects requested by client
- Encourage strategic changes within the client benefits to enhance member outcomes
- Explain pharmacy programs and possible effects and outcomes to client.
- Support UHCP clinical team
- Drug utilization review
- Other requests as needed
- Represent clinical in workgroups both within UHCP and external
- Coverage reviews back-up support
- Do second level appeals as needed
- Cover first level appeals when necessary
- Ensure all policies and procedures are followed when doing appeals
- Integration between UHCP, OptumHealth and Medco - participate in process
1. Work as part of all subgroups to ensure all groups working together toward common goals
2. Provide clinical pharmacy input as needed
Qualifications:
- Bachelor of Science in Pharmacy or Doctor of Pharmacy degree required
- Must hold at least one valid pharmacist license without restrictions
- Must maintain a valid pharmacist license
- Strong clinical and analytic background
- At least 7 years of managed care or PBM experience preferred
- At least 5 years of client facing or clinical account management experience preferred
- At least 2-3 years experience in managing staff
OptumRx is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. In the largest and most personal sense, your impact can be greater than even you thought at OptumRx.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.