Clinical Consultant

Clinical Consultant

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 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
• 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 strong initiative
• Demonstrates high achievement drive
• Proven to exhibit 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 clinical and analytic background
• Demonstrated strong presentation skills and experience
• Proven ability to successfully manage multiple clients simultaneously

Competencies and Best Practice for High Performers (List competencies and at least two behavioral anchors for each):

• 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

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