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Associate Director Clinical Consulting, Medicaid

4 months ago

Nashville, United States Optum Full time

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.

This Associate Director of Clinical Consulting will oversee clinical consulting client relationships, proactively identify clinical solutions, and manage clinical resource allocation for the Public Sector of OptumRx's segments of Clinical Consulting support. They will work with clinical leadership in developing a strategy related to the delivery of proactive consultative services and driving clinical upsell targets, including deployment of appropriate use guidelines and protocols, utilization management strategies, clinical products / services and formulary management strategies. The Associated Director of Clinical Consulting is expected to maintain strategic relationships with client leaders, key stakeholders, and brokers/consultants.

The Director of Clinical Consulting is accountable for direct management of a staff of clinical consultants and maintaining client satisfaction and retention.

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

Primary Responsibilities:

Lead and motivate a team of Clinical Consultant Pharmacists to deliver results

Provides mentoring / coaching for Clinical Consultants in order to enhance employee engagement, promote professional development and maintain high levels of staff satisfaction

Assist in the recruitment, on-boarding and mentoring of new Clinical Consultant team members

Determine and manage clinical consulting resource allocation and assignment

Provide routine reporting to clinical leadership regarding milestone attainment and any significant issues within their segment that may be impacting overall team performance

Maintains understanding of individual client contracts and ensures proper execution of all clinical deliverables specific to those agreements

Ensures alignment of PBM clinical priorities with strategic goals and objectives of the overall organization and client

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,

PDL and or formulary

compliance targets, and HEDIS & NCQA measures

Formulates and delivers clinically-sound and fiscally responsible recommendations to clients based on trend

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

Comprehends and effectively explains

PDL and

formulary and clinical program changes to clients

Stays aware of and provides clinical market intelligence to clients

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

Communicates drug information to clients and responds to plan-specific clinical inquiries in a timely manner

Supports other revenue-enhancement efforts (e.g., specialty, formulary,

PDL,

UM, mail, etc...) in coordination with client mgmt./sales teams where appropriate

Routinely collaborates with client management leadership peers to provide well-coordinated, impactful quarterly performance review sessions with clients

Serves a key resource for new clinical product/service ideation and liaison to clinical product development / management areas to create new or enhance existing programs

Identifies and collaborates with account management on clinical renewal strategies

Drives enhanced client relationships through senior-level strategic discussions and planning which addresses issues of highest priority for the client

Consistently looks at existing processes, methods, and materials to find opportunities for improvement

Maintains strategic relationships with client leaders, key stakeholders, and brokers/consultants

Supports sales and marketing including participating in RFP/finalist activities as needed based on current standard operating procedure

Serves as Subject Matter Expert (SME) for other departments on Clinical Consulting-specific issues/inquiries

Actively participates in, and in some cases leads departmental and interdepartmental workgroup and project work

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 in the state of Tennessee

5+ years of pharmacy practice experience

3+ years of direct management experience, leading teams to deliver results

2+ years of Medicaid experienceincluding PDL and formulary experience with Medicaid UM development and public health policy experience

1+ years of clinical account management experience within UnitedHealth Group, OR 2+ years of clinical account management experience within a PBM, Managed Care or State insurance plan, interfacing with external clients (beyond patients and prescribers) and delivering formal client presentations

Basic competency in Microsoft Word, Excel, PowerPoint, Teams, and Outlook

Ability and willingness to travel up to 20%

Primary residence in the state of Tennessee

Preferred Qualifications:

MBA or similar advanced degree

Formalized sales skills training

Formalized leadership skills training

Formalized presentation skills training

Well-rounded clinical account management experience working across multiple lines of business including Commercial and Government clients

Experience working with complex government clients w/complex benefit structures

Experience communicating with executive leadership

Conflict resolution experience

Medicare D experience

Medicaid Fee-For-Service 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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