Account Manager Pharmacist Clinical Consultant, Medicaid Fee For Service
1 month ago
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.
-
South Burlington, United States UnitedHealth Group Full timeOptum 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,...
-
South Burlington, United States UnitedHealth Group Full timeOptum 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,...
-
Pharmacist (Night) Lead
2 weeks ago
Burlington, United States The University of Vermont Medical Center Full timeJOB DESCRIPTION : The Night Lead Pharmacist serves as the sole Pharmacist resource during the night shift. The Night Lead Pharmacist assures the appropriateness of drug therapy as described in the position accountabilities from a hospital-wide shift-specific perspective. The Night Lead Pharmacist is responsible for ensuring that the medication needs of...
-
Clinical Pharmacist
4 weeks ago
South Bend, Indiana, United States tapwage Full timeTypical pay range: $ $89.65ST.CHARLES HEALTH SYSTEMJOB DESCRIPTIONTITLE:Clinical PharmacistREPORTS TO POSITION:VariesDEPARTMENT:PharmacyDATE LAST REVIEWED:August 29, 2022OUR VISION:Creating America's healthiest community, togetherOUR MISSION:In the spirit of love and compassion, better health, better care, better valueOUR VALUES:Accountability, Caring and...
-
Clinical Pharmacist
1 month ago
South Bend, Indiana, United States tapwage Full timeTypical pay range: $ $89.65ST.CHARLES HEALTH SYSTEMJOB DESCRIPTIONTITLE:Clinical PharmacistREPORTS TO POSITION:VariesDEPARTMENT:PharmacyDATE LAST REVIEWED:August 29, 2022OUR VISION:Creating America's healthiest community, togetherOUR MISSION:In the spirit of love and compassion, better health, better care, better valueOUR VALUES:Accountability, Caring and...
-
Community-Based Fee-For-Service Counselors
1 month ago
South Portland, United States Day One Full timeJob DescriptionJob DescriptionGeneral Summary:Child and adult fee-for-service counselors willing to commit between 10 - 20 hours in the Southern Maine area. Flexibility in location to provide services, including home telehealth.Provide substance use and/or mental health counseling, including assessment, treatment planning, group counseling, individual...
-
Community-Based Fee-For-Service Counselors
4 weeks ago
South Portland, United States Day One Full timeJob DescriptionJob DescriptionGeneral Summary:Child and adult fee-for-service counselors willing to commit between 10 - 20 hours in the Southern Maine area. Flexibility in location to provide services, including home telehealth.Provide substance use and/or mental health counseling, including assessment, treatment planning, group counseling, individual...
-
South Portland, United States Maine Health Full timeFull Time 22 Bramhall St. Professional - Clinical Day Shift * ($5,000.00 Sign on Bonus paid in 3 installments, prorated for Part Time) * * Current MaineHealth employees not eligible for the sign on bonus. Must be separated from MaineHealth system for 6 months to be eligible. * * Position Summary * We thrive at our ambulatory oncology practice because...
-
South Portland, United States Maine Health Full timeFull Time 22 Bramhall St. Professional - Clinical Day Shift * ($5,000.00 Sign on Bonus paid in 3 installments, prorated for Part Time) * * Current MaineHealth employees not eligible for the sign on bonus. Must be separated from MaineHealth system for 6 months to be eligible. * * Position Summary * We thrive at our ambulatory oncology practice because...
-
PICU Pharmacist, Residency Trained
1 month ago
South Houston, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Clinical Oncology Pharmacist
2 months ago
South Portland, United States Maine Medical Center Full timeSummary ($5,000.00 Sign on Bonus paid in 3 installments, prorated for Part Time) Current MaineHealth employees not eligible for the sign on bonus. Must be separated from MaineHealth system for 6 months to be eligible. Position Summary We thrive at our ambulatory oncology practice because of the people and our shared dedication to provide our patients with...
-
Clinical Oncology Pharmacist
4 weeks ago
South Portland, United States Maine Medical Center Full timeSummary ($5,000.00 Sign on Bonus paid in 3 installments, prorated for Part Time) Current MaineHealth employees not eligible for the sign on bonus. Must be separated from MaineHealth system for 6 months to be eligible. Position Summary We thrive at our ambulatory oncology practice because of the people and our shared dedication to provide our patients with...
-
Travel Pharmacist in Burlington, VT
6 days ago
South Burlington, United States CompHealth Full timeCome join our team of healthcare professionals at our teaching hospital here in beautiful Vermont as the subject matter expert in ED Pharmacy. We are looking for someone who can step in and be a strong contributor to our pharmacy program including being a primary preceptor for our PGY pharmacy residents that rotate through. Our hospital is one of the best...
-
Supervising Pharmacist
3 weeks ago
Burlington, United States Quad Recruitment LTD Full time*Supervising Pharmacist**Up to $78 per hour**Burlington, VT**Monday – Friday with rotating weekends*Are you frustrated not being able to use your abilities and skills in your current role?You’re not alone…This is a totally employee-owned company so your performance and contributions will reward you year in year out. Our CEO and VP are pharmacists, so...
-
Pharmacist
2 months ago
South Bend, United States Beacon Health System Full timePRN 615 N. Michigan Street Pharmacy Day Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and procedures. Oversees, reviews and checks all work of technical and student support staff when that work...
-
Pharmacist
1 month ago
South Bend, United States Beacon Health System Full timeFull-time 615 N. Michigan Street Pharmacy Night $5,000 Sign-On Bonus Available! Premium Pay; 10% Shift Differential Offered for Night Shift! Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and...
-
Pharmacist
2 months ago
South Bend, United States Beacon Health System Full timePart-time 615 N. Michigan Street Pharmacy Day $2,500 Sign-On Bonus Available! Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and procedures. Oversees, reviews and checks all work of technical and...
-
Pharmacist
4 weeks ago
South Bend, United States Beacon Health System Full timePart-time 615 N. Michigan Street Pharmacy Day $2,500 Sign-On Bonus Available! Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and procedures. Oversees, reviews and checks all work of technical and...
-
Pharmacist
4 weeks ago
South Bend, United States Beacon Health System Full timePRN 615 N. Michigan Street Pharmacy Day Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and procedures. Oversees, reviews and checks all work of technical and student support staff when that work...
-
Pharmacist
4 weeks ago
South Bend, United States Beacon Health System Full timeFull-time 615 N. Michigan Street Pharmacy Night $5,000 Sign-On Bonus Available! Premium Pay; 10% Shift Differential Offered for Night Shift! Reports to the Pharmacy Manager. Provides efficient and accurate dispensing of pharmaceuticals in accordance with legal, regulatory and accrediting agency standards and in accordance with hospital policies and...
