Clinical Consultant & Academic Detailer Pharmacist

UnitedHealth Group • Schaumburg, IL

314d • $89,800 - $176,700 • Remote

About The Position

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 Clinical Consultant / Academic Detailer 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. Works under the guidance and direction of their health plan partner to successfully drive initiatives and engage providers and medical group administrators in an educational capacity with the goals of driving adherence to evidence-based medicine guidelines, supporting medication adherence, and supporting prescribing of lower cost alternatives.

Requirements

• Bachelor's degree in Pharmacy or Pharm D
• Current and unrestricted Pharmacist license
• 3+ years of experience working as a licensed pharmacist
• Experience working for a PBM and / or Health Plan in a client-facing role with external clients (beyond patients and prescribers)
• Experience analyzing and interpreting pharmacy claims data, cost drivers and trends
• Experience developing and delivering formal presentations for external clients
• Proficient in Microsoft Office and Outlook
• Ability to travel up to 25%

Nice To Haves

• Clinical account management experience
• Experience working with complex Health Plan clients with complex benefit structures including Commercial and/or Exchange and/or Medicare and/or Medicaid plans
• Experience proactively outreaching to providers or provider offices on pharmacy recommendations and topics driving change through collaboration
• Academic Detailing experience
• Solid clinical knowledge and experience collaborating with providers to recommend or promote clinically appropriate and cost-effective care
• General pharmacy/PBM, medical practices business understanding related to prescribing
• Understanding of clinical quality programs (i.e. CMS STAR Ratings, NCQA/HEDIS, PQA)
• Understanding of pay-for-performance programs, ACOs and other performance/quality based initiatives

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
• Build collaborative and trusting relationships with the providers, working as a clinical liaison between health plan partner and portfolio of practices/providers
• Engage top prescribers through face-to-face visits, telephonic outreach, and fax/mail intervention to provide them with key feedback on their prescribing patterns, including benchmarks against relevant peer groups
• Review prescriber-specific opportunities to improve care on behalf of members
• Review patient-specific opportunities to optimize and provide cost-effective, quality care
• Communicates drug information to clients and responds to plan - specific clinical inquiries
• Participate in the development of reports providing comparative data on prescribing practices, and outcome reports to track and trend program impact and identify areas of opportunity to improve the program
• 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, and presentation of each year's activities and outcomes
• 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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree