Clinical Consultant Pharmacist

About the role

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.

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
• 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

Requirements

• 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 solid initiative
• Demonstrates high achievement drive
• Demonstrates competent problem-solving skills
• Demonstrates 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 presentation skills and experience
• Demonstrated solid clinical and analytic background
• Proven ability to successfully manage multiple clients simultaneously

Competencies and Best Practice for High Performers

• Generally, work is self-directed and not prescribed
• Works with less structured, more complex issues
• Serves as a resource to others
• Coaches, provides feedback, and guides others
• Communicates effectively both orally and written
• Strong communication, presentation, interpersonal, and computer skills
• Team player
• Knowledgeable about drug development pipeline and new generics
• Expert on industry best practices
• Thoroughly knowledgeable on clinical program outcomes
• Familiar with clinical rules for formulary management and clinical edits
• 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
• Highly responsive to internal and client requests, questions, and communications
• Proactive; anticipates client needs and trends
• Targets messages to varied audiences based on client experience

Pay

The salary for this role will range from $91,700 - $163,700 annually based on full-time employment.