Clinical Consultant Pharmacist, Health Plan

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 & 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
• Able to incorporate treatment & practice guidelines into client presentations including up-selling opportunities
• Able to effectively manage client objections to new programs and required changes
• Manages/facilitates custom P&T committees for select clients
• Able to analyze & interpret benefit designs
• 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

Required Qualifications

• Bachelor of Science in Pharmacy or PharmD
• Active, unrestricted US state-specific pharmacist license
• 1+ years of client facing or clinical account management experience
• 1+ years of Health Plan experience
• Medicare experience
• Proficient skills in Microsoft Office and Outlook
• Ability to travel up to 10%

Preferred Qualifications

• Experience giving formal presentations
• Medicaid experience
• Experience in data analytics and drawing insights
• Experience in Rx Claim
• Experience in IQP
• Experience in MediSpan
• Experience in Reporting 360

Benefits

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).

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.