Clinical Consultant
$91.7k - $163.7kUnitedHealth Group
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 * 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 - $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 improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
- ...Overview We are seeking a dynamic clinical professional to strengthen and advance customer relationships through strategic clinical... ...In this role, you will provide impactful education, training, consultative support, and formal presentations to ensure customers are confident...Suggested
- Clinical Applications Consultant: Dallas, TX Position Summary Responsible for ensuring total customer satisfaction within the Werfen installed base. Perform installations, validations/verification and training on Werfen analyzers. Provide ongoing clinical support, customer...SuggestedWork experience placement
- A specialized diagnostics company is seeking a Clinical Applications Consultant in Dallas, TX. The role involves ensuring customer satisfaction, providing support and training on medical instruments. Candidates should have an Associates degree and 2-3 years of clinical...Suggested
$112.7k - $193.2k
...The Texas Health Institute is seeking a Clinical Quality Consultant for the Oncogenetic Program. This role ensures compliance with regulatory standards and optimal outcomes in oncology through expert data interpretation and collaboration in a remote work environment. You...SuggestedRemote work- ...The Council of State and Territorial Epidemiologists is looking for a Clinical Quality Consultant to support the Oncogenetic Program. This role involves ensuring optimal patient outcomes through the analysis of genomic data, compliance with regulations, and collaboration...SuggestedRemote work
$112.7k - $193.2k
...UnitedHealth Group is looking for a Clinical Quality Consultant for the Oncogenetic Program to provide support for advanced molecular and genetic testing in oncology. You will be responsible for ensuring compliance with regulatory standards while working remotely. A PhD...Remote work- ...development efforts, including proposals and interviews Translate clinical operations, patient experience goals, and project priorities... ...and build consensus Coordinate multidisciplinary teams and consultants to ensure alignment with planning intent and project objectives...Full timeWork at officeMonday to Friday
$114.61k - $199.06k
Elevance Health seeks a Remote Coding Specialist responsible for conducting comprehensive chart reviews and ensuring accurate coding according to HCC and CMS guidelines. Qualified candidates must hold a Master's in Nursing and possess a valid RN and NP license. This role...Remote jobFull time$112.7k - $193.2k
UnitedHealth Group is seeking a Clinical Quality Consultant for the Oncogenetic Program, responsible for guiding utilization management related to genetic testing. This role allows for remote work from anywhere in the U.S. Candidates should have a PhD in molecular pathology...Remote job$112.7k - $193.2k
...Clinical Quality Consultant For The Oncogenetic Program 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...Remote jobMinimum wageFull timeWork experience placementLocal area- Corgan Associates Inc. is seeking a dynamic Senior Healthcare Planner in Dallas, Texas to lead healthcare planning from visioning through construction. This full-time on-site role requires a professional degree in Architecture or Interior Design and at least 8 years of ...Full time
- Perkins & Will Inc. is seeking a Senior Medical Planner in Dallas, Texas, to lead the design process for healthcare facilities. This role involves collaboration with clients and healthcare groups to meet project goals, while also ensuring quality and adherence to architectural...
- Job Summary The Healthcare Construction Consultant manages the flow of information between hospital departments and contractors, oversees... ...a background in project management, facility maintenance, or clinical operations. Education: Bachelor’s degree in construction...For contractors
$110k - $120k
...medical literature to support Association programs. Ideal candidates should have a graduate degree in a health profession, substantial clinical experience, and strong communication skills. This role offers a competitive salary between $110,000 and $120,000, alongside...- ...Join Our Dynamic Team as a Senior Healthcare Recruiting Consultant About MLR At MLR, we are not just another healthcare staffing and recruiting service; we are trailblazers in the field. With more than twenty years of experience under our belt, we've forged a...Permanent employmentRemote work
$95k - $145k
...Healthcare Strategy Consultant (Entry-Level) – Career Launch AI Talent Network Location: San Francisco, CA & New York, NY Compensation... ...Help structure insights gathered from research, data, and clinical subject-matter experts Ideal Candidate Profile Bachelor’...Full time- Policy Analyst Location: Irving TX or Tampa/Jacksonville FL – Hybrid Contract: 12 months with potential extension Job Description: Client’s PBWM Technology (PBWMT) organization serves the PBWM global suite of products providing a full range of innovative and...Contract workWorldwideFlexible hours
- ...A leading global consulting firm is seeking an entry-level Healthcare Strategy Consultant to support projects in healthcare systems and digital health. Ideal candidates hold a relevant bachelor's degree and have a strong interest in health technology. You will conduct...
$19.5 - $24.25 per hour
AMN Healthcare is looking for a Recruiter for Physician & Leadership roles in Dallas, Texas. This position focuses on sourcing and assessing candidates for Executive Search, ensuring effective pipeline management for open positions. The ideal candidate will possess strong...Hourly pay- West Coast University, Inc. is seeking an Admission Advisor to guide prospective students toward a career in healthcare. In this role, you will support students through the application and enrollment process while building strong relationships through communication. The...
- Orion Health is seeking an Implementation Consultant to join the Professional Services Group in Dallas, TX. You will install and configure software and hardware, liaise with clients, and transfer knowledge to ensure successful implementation and client satisfaction. As...
- A leading healthcare consultancy is seeking a Business Development Consultant to expand their reach in a defined territory. The successful candidate will manage client relationships, conduct webinars, and effectively communicate with healthcare executives. A strong background...Remote job
- ...experience in Information Security Analysis, along with a solid background in Data Loss Prevention. Key responsibilities include consulting on Information Security initiatives and collaborating with client personnel. Candidates should have experience with DLP policy creation...
- ...capture. How You'll Make a Difference: Primary duties may include, but are not limited to: Focus on chart reviews by supplying clinical expertise to ensure full accurate and appropriate diagnosis, documentation, coding and care. Will review all provider visit...Full timeTemporary workWork experience placementWork at officeLocal area1 day per week
- Forvis Mazars US in Dallas, Texas is seeking a healthcare consultant to guide strategic initiatives enhancing profitability and operational efficiency. The role includes leading data analysis, mentoring junior members, and fostering relationships with healthcare leaders...
- ...services in the facility and related Community Based Outpatient Clinics (CBOCs) as it relates to access to care as applicable.... ...include but not limited to: Incumbent will provide access related consultative services to multiple services in a fast‑changing environment -...Local areaMonday to Friday
- Baylor Scott & White Health is seeking an IS Operations Consultant to provide strategic consulting and planning services with wide influence and impact. The ideal candidate will utilize their expertise in technology, change management, project management, and process improvement...
- Forvis Mazars US is seeking a professional in healthcare consulting to guide strategic vision and operational assessments within healthcare organizations. The ideal candidate should possess a Bachelor's or Master's Degree in a relevant discipline and have strong skills...Work at office
- Forvis Mazars US is seeking a Finance & Strategy Consultant to empower healthcare leaders in managing growth and quality care delivery in Dallas, Texas. The role involves guiding organizations and analyzing data regarding performance, while collaborating with various service...Flexible hours
- Overview Candidate must be located in the Dallas, TX area Blackstone Medical Services is dedicated to providing exceptional at-home sleep testing for sleep apnea. We support healthcare providers with the resources they need to deliver high-quality patient care. We're committed...Work at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Consultant. Be the first to apply!

