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Account Manager Pharmacist Clinical Consultant, Health Plans - Pacific, Mountain or Central Time Zones Preferred


Account Manager


Schaumburg, Illinois, United States

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

You're looking for something bigger for your career. How about inventing the future of health care? OptumRx is creating an innovative approach to Pharmacy Benefit Management. Here you'll find a professional culture where you can use your talent and our resources to make an impact on a huge scale. With better schedules than retail and more reach than any hospital, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

The Account Manager Pharmacist / Clinical Consultant will lead and manage ongoing contract relationships and pharmacy benefit analysis and consultation delivery to clients. Collaborate in development of strategy as outward - facing, dedicated resources for assigned accounts, typically with direct client contact for large / complex accounts. Builds client relationships and serves as primary point of contact for overall and day - to - day service delivery for clinical pharmacy needs. Represents client(s) internally and coordinates with other functions to implement client systems, complete projects, and address ongoing pharmacy service needs. The Clinical Consultant serves as the primary liaison between OptumRx clinical operations, professional practice, and clinical products and the consultant’s assigned client base. The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments. This individual is relied upon to provide proactive clinical recommendations, information regarding pharmacy trend, programs, and industry changes to clients and to foster consultative relationships.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

You will have the flexibility to work remotely* as you take on some tough challenges. Candidates residing in Pacific, Mountain or Central Time zone are preferred.

Primary Responsibilities:

  • Collaborates 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 and NCQA measures
  • Provides superior clinical consultation and clinical account management with a focus on client satisfaction, client retention, and trend management
  • Comprehends and effectively explains formulary and clinical program changes to clients
  • Stays aware of and provides clinical market intelligence to clients
  • Provides education for clients, pharmacists, members, and physicians per contractual requirements
  • Communicates drug information to clients and responds to plan - specific clinical inquiries
  • Formulates and delivers client recommendations based on available data
  • Identifies opportunities for clinical program up - sell
  • Makes clinically sound recommendations to clients based on trend
  • Routinely collaborates with account management to provide clinical aspects of client quarterly reviews
  • Demonstrated ability to incorporate treatment and practice guidelines into client presentations including up - selling opportunities
  • Effectively manages client objections to new programs and required changes
  • Manages / Facilitates custom P&T committees for select clients
  • Analyzes and interprets benefit designs
  • Facilitates ongoing maintenance of client custom formulary and utilization management updates
  • Clearly communicates analytical and reporting needs to supporting departments
  • Identifies and creates opportunities to manage trend and add OptumRx products
  • Supports sales and marketing including participating in sales activities, as needed based on criteria
  • Helps clients be competitive within their market
  • Identifies opportunities to increase efficiency
  • Mentors clinical coordinators, as needed

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's degree in Pharmacy or Pharm D
  • Current and unrestricted Pharmacist license
  • 3+ years of experience working as a licensed pharmacist
  • 2+ years of Medicare experience with CMS regulations and/or Part D Formulary management
  • Experience working for a PBM and / or Health Plan in a client-facing role with external clients (beyond patients and prescribers)
  • Experience developing and delivering formal presentations for external clients
  • Proficient in Microsoft Office and Outlook
  • Ability to travel up to 25%

Preferred Qualifications:

  • Clinical account management experience
  • Medicare experience
  • Experience working with complex Health Plan clients with complex benefit structures

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)

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

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.

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.