Account Consultant Pharmacist - Remote in HI Only

UnitedHealth Group•Honolulu, HI

5d•$112,700 - $193,200•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Providing outstanding service to our Medicaid Health plans takes a solid mix of business skills, technical proficiency, and industry knowledge. We have a strong team of pharmacists and pharmacy service specialists, and we are looking for a talented individual to join us as we grow our business. In this position, our new team member will have the opportunity to develop expertise in the Medicaid and DSNP business. The Plan Pharmacy Director serves as the primary point of contact and is accountable to the UnitedHealthcare Community Plan of Hawaii Plan leadership and the state Medicaid agency related to execution of the pharmacy benefit program and strategy. Position is Plan Pharmacy Director, a dedicated resource and key staff of the UnitedHealthcare Community Plan of Hawaii health plan; that is accountable for setting the strategic direction, operational execution, oversight and financial impact analysis of pharmacy program priorities for the health plan. The role includes preferred drug list (PDL) implementation and maintenance activities, pharmacy reporting, management of state pharmacy relationship, active engagement at pharmacy related meetings with internal and external stakeholders as the pharmacy subject matter expert, key contact for pharmacy to internal and external stakeholders, developing and executing pharmacy strategy, ensuring pharmacy benefit compliance, communicating pharmacy trends and value proposition, developing and executing on affordability initiatives, supporting clinical and quality initiatives. This position will be part of the UnitedHealthcare Community and State Pharmacy team, reporting directly into the Regional Director Pharmacy Services. If you are in the State of Hawaii, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

B.S.Pharm or Pharm.D
Current, unrestricted Hawaii Pharmacist license
1+ years of Clinical Pharmacy, Sales, or Account Management experience or combination thereof
1+ years of experience in Managed Care Pharmacy either in a Health Plan or PBM
1+ years of direct experience with Medicaid/Medicare plans
Experience in engaging, and presenting, to groups including senior level management
Experience working with pharmacy data and experience with Pharmacy Utilization Review and understanding pharmacy trend
Intermediate to advance proficiency in Microsoft Office Suite, including Word, Excel and PowerPoint
Proven excellent verbal and written communication skills
Proven ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Proven highly motivated and self-directed
Proven excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Candidates are required to pass a drug test before beginning employment.

Responsibilities

Executes the pharmacy benefit and compliance with the state contract, state policies, and state/federal statutes and regulations governing pharmacy
Utilizes broad understanding of managed care and PBM knowledge to develop, execute, and drive strategic plans and goals
Analyzes forecasting and trend information for operational and business planning
Provides strategic direction, operational oversight, and financial impact analysis as it pertains to pharmacy program priorities for the health plan
Builds and maintain strong relationships with internal and external partners and serve as the primary point of contact for Pharmacy and Pharmacy Services
Assists plan on all pharmacy related activities including clinical program development and improving member satisfaction
Accountable for creation and maintenance of state specific polices
Serves as the SME SPOC for formulary, prior authorization and benefit coding requirements and execution and responsible for communication with stakeholders for implementation
Demonstrates a strong working knowledge of health plan operations (compliance, finance, encounters, claims adjudications, networks, clinical, case management, HEDIS measures, etc.)
Collaborates with internal partners to complete projects and to address on-going pharmacy service needs of the plan
Conducts and manages outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning
Communicates pharmacy program changes with the assigned health plans key departments
Provides strategic solutions using the baseline pharmacy capabilities library to support plan priorities across various domains
Engages state Medicaid, pharmacy and health plan association meetings and build relationships as the health plan pharmacy subject matter expert
Ensures timely submission of accurate pharmacy reports and deliverables as required by the state Medicaid agency and the health plan
Supports the health plan departments to ensure resolution of pharmacy related issues
Learns, understands and lives the United cultural values
Understands actions and communication relevant to changes and/or updates in relevant policies, procedures, and regulations
Trains and educates team and internal stakeholders on relevant policies and procedures related to the pharmacy benefit
Other duties as assigned