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Job Information

UnitedHealth Group Senior Clinical Consultant- Telecommute - West Coast Preferred in Eden Prairie, Minnesota

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Senior Clinical Consultant serves as the primary liaison between OptumRx clinical operations, professional practice, and clinical products and the Clinical Consultant’s assigned Public Sector client base. The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments. The Senior 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 with large, complex and/or strategic clients. 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. In addition, the Senior Clinical Consultant supports the clinical pharmacy team with formulary development, clinical program development and clinical pharmacy functions as the need arises. The Senior Clinical Consultant translates United Health Group’s culture and values into action and is a role model for Clinical Consultants on the team.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges, however candidates residing in Alaskan, Pacific or Mountain time zones will be given preference.

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 OptumRx 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

  • Demonstrate critical thinking by analyzing relevant information with multiple methods

  • Generate innovative ideas that can be scaled across the organization

  • Develop clinical strategy as outward-facing, direct client contact for large, complex and/or strategic accounts

  • Clearly communicate analytical and reporting needs to supporting departments

  • Help clients be competitive within their market

  • Identify opportunities to increase efficiency

  • Lead and manage ongoing contract relationships and pharmacy benefit analysis and consultation delivery to clients

  • 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 & strategic Finalist activities, per department policies

  • Serve as subject matter expert in one or multiple areas and represent Clinical Consulting department in these areas - internally and externally

  • Assist in training new Clinical Consultants – in part or in whole

  • Assist in development of existing Clinical Consultants

  • Provide administrative/management/leadership back-up support to Director as necessary

  • Drive enhanced client relationships through senior-level strategic discussions and planning which addresses issues of highest priority to the client

  • Maintain familiarity with assigned client contract terms; particularly pricing of clinical programs/services, and is able to actively engage in contract renewal negotiations as needed

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

  • Maintain strategic relationships with client leaders, key stakeholders, and brokers/consultants while maintaining focus on UHG and Optum strategies and goals

  • Serve as Subject Matter Expert (SME) for other departments on Clinical Consulting-specific issues/inquires

  • Routinely identify, develop and share best practice experience with peers

  • Mentor new clinical consultants when requested

  • Mentor clinical consultants on the team when requested

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

  • 10+ years of pharmacy practice experience

  • 3+ years of clinical account management experience within a PBM or Managed Care, including external client-facing (beyond patients and prescribers) responsibilities

  • 2+ years of experience providing formal client presentations

  • Extensive experience analyzing claims data, interpreting spend & trend, and making proactive recommendations to reduce cost and improve outcomes

  • Proficiency in Microsoft Word, Excel, PowerPoint, Teams, and Outlook

  • Ability and willingness to travel up to 50% (travel currently suspended; expectation upon re-instatement of business travel)

  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • 5+ years of managed care or PBM experience

  • ASHP/AMCP-accredited residency in Managed Care

  • Experience working directly with Public Sector clients and/or government programs

  • EGWP experience

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with OptumRx . We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut / Nevada residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.