Senior Clinical Consultant

About the role

The Senior Clinical Consultant serves as the primary liaison between OptumRx clinical operations, professional practice, and 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 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
• Manage/facilitates custom P&T committees for select clients, per contractual requirements
• Provide education for clients, pharmacists, members and physicians per contractual requirements
• Serve as subject matter expert in one or multiple areas and represent Clinical Consulting department in these areas - internally and externally
• Aid in training new Clinical Consultants - in part or in whole
• Aid in development of existing Clinical Consultants
• 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

Qualifications

• Bachelor of Science in Pharmacy or Doctor of Pharmacy degree
• Active, unrestricted US state-specific pharmacist license
• 5+ years of pharmacy practice experience or equivalent
• 3+ years of client facing or clinical account management experience
• 3+ years of PBM experience
• 2+ years of experience providing formal client presentations
• Experience managing multiple clients simultaneously
• Experience prioritizing customer-centric activities
• Ability and willingness to travel up to 10% of the time

Preferred Qualifications

• Specialty Pharmacy experience
• Medicaid experience
• Intermediate level competency in Microsoft Word, Excel, PowerPoint, Teams and Outlook