Clinical Pharmacist - Remote in CST or EST
The Clinical Pharmacist will support the Clinical Pharmacy team by developing and maintaining drug policies for the pharmacy and medical benefit, supporting United's Medicaid line of business. This role will partner with peers supporting formulary and trend management, clinical pharmacy operations, drug utilization review programs, and state partners to develop and implement clinical programs and formularies that support plan objectives and organizational growth goals. The ideal candidate will be able to provide subject matter expertise across both the pharmacy and medical drug benefit, have a strong understanding of process development and implementation and possess a strong analytical skillset with the ability to turn large datasets into end user formats to be used to measure performance and/or support clinical decision making.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
• Support the strategy and development of formularies for the Medicaid business to provide clinically sound and affordable care for members, while meeting all government required regulations
• Build and maintain utilization management programs for the Medicaid business. These programs include but are not limited to prior authorization, quantity limits, and step therapy edits
• Discuss proposed policies with key stakeholders
• Measure and report the value of utilization management programs for the Medicaid business
• Serve as a clinical liaison to our National Pharmacy and Therapeutics Committee, including presenting utilization management programs for approval
• Develop strong partnerships with cross functional team members, including from our PBM, to support the Medicaid business
• Help support appeals team on member and provider appeals of coverage decisions
• Problem solve and recommend approaches based on review of clinical literature
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:
• Registered Pharmacist with license in good standing within a US State or Territory
• 3+ years of clinical pharmacy experience or completion of a managed care pharmacy residency
• Experience with writing/developing utilization management criteria for medications available on the pharmacy benefit
• Experience with presenting clinical content and recommendations to various audiences
• Solid proficiency in Sharepoint, MS Office Suite (including Excel)
• Solid organizational skills with the ability to balance multiple tasks and both accept direction, and self-manage daily activities
• Skilled communicator with an ability to adapt written and verbal communications to needs of audience
• Ability to work both independently and within a matrixed team environment to deliver objectives within an established timeline
• Demonstrated curiosity and willingness to adopt new tools and approaches, including AI-enabled analytics or automation such as CoPilot, to improve efficiency and effectiveness
Preferred Qualifications:
• Completion of a managed care pharmacy residency
• Attained Board of Pharmacy Specialties (BPS) certification or other equivalent accredited pharmacy board certification
• Experience with writing/developing utilization management criteria for physician administered medications
• Experience with Microsoft Access and advanced analytical tools such as Tableau, SQL, and/or SAS
• Proven analytical skills with an ability to sift through data and identify solutions to solve problems
• Demonstrated ability to build internal and external relationships with key stakeholders
• 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.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
• Support the strategy and development of formularies for the Medicaid business to provide clinically sound and affordable care for members, while meeting all government required regulations
• Build and maintain utilization management programs for the Medicaid business. These programs include but are not limited to prior authorization, quantity limits, and step therapy edits
• Discuss proposed policies with key stakeholders
• Measure and report the value of utilization management programs for the Medicaid business
• Serve as a clinical liaison to our National Pharmacy and Therapeutics Committee, including presenting utilization management programs for approval
• Develop strong partnerships with cross functional team members, including from our PBM, to support the Medicaid business
• Help support appeals team on member and provider appeals of coverage decisions
• Problem solve and recommend approaches based on review of clinical literature
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:
• Registered Pharmacist with license in good standing within a US State or Territory
• 3+ years of clinical pharmacy experience or completion of a managed care pharmacy residency
• Experience with writing/developing utilization management criteria for medications available on the pharmacy benefit
• Experience with presenting clinical content and recommendations to various audiences
• Solid proficiency in Sharepoint, MS Office Suite (including Excel)
• Solid organizational skills with the ability to balance multiple tasks and both accept direction, and self-manage daily activities
• Skilled communicator with an ability to adapt written and verbal communications to needs of audience
• Ability to work both independently and within a matrixed team environment to deliver objectives within an established timeline
• Demonstrated curiosity and willingness to adopt new tools and approaches, including AI-enabled analytics or automation such as CoPilot, to improve efficiency and effectiveness
Preferred Qualifications:
• Completion of a managed care pharmacy residency
• Attained Board of Pharmacy Specialties (BPS) certification or other equivalent accredited pharmacy board certification
• Experience with writing/developing utilization management criteria for physician administered medications
• Experience with Microsoft Access and advanced analytical tools such as Tableau, SQL, and/or SAS
• Proven analytical skills with an ability to sift through data and identify solutions to solve problems
• Demonstrated ability to build internal and external relationships with key stakeholders
• 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.