The Clinical Consultant, TPA 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, TPA 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.
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
- Experience building strong relationships with clients
- Experience taking initiative and working independently.
- Basic competency in Microsoft Word, Excel, PowerPoint, Teams and Outlook
- Demonstrated ability and willingness to travel
- Demonstrated track record of achieving results in a fast-paced environment.
- Demonstrated solid problem-solving skills with the ability to resolve complex challenges.
- Demonstrated 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
- Experience successfully managing multiple clients simultaneously
- Knowledge in clinical best practices
*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 to $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.
