Clinical Consultant Pharmacist, Health Plans
About The Position
Lead and manage ongoing contract relationships, 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. The Clinical Consultant Pharmacist serves as the primary liaison between OptumRx clinical operations, professional practice, and clinical products for the consultant’s assigned client base. The role provides clinical support for OptumRx account management, operations, information technology, and other internal departments. This individual is relied upon to provide proactive clinical recommendations, information regarding pharmacy trend, programs and industry changes to clients and to foster consultative relationships.
Requirements
- 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
- Proficient skills in Microsoft Office and Outlook
- Ability to travel up to 10%
Nice To Haves
- Medicare experience
- Experience giving formal presentations
- Experience in data analytics and drawing insights
- Experience in Rx Claim
- Experience in IQPR
- Experience in MediSpan
- Experience in Reporting 360
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
- Provide 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
- Formulate and deliver client recommendations based on available data
- Identifies opportunities for clinical program up-sell
- Makes clinically sound recommendations to clients based on trend
- Routinely collaborating with account management to provide clinical aspects of client quarterly reviews
- Able to incorporate treatment & practice guidelines into client presentations including up-selling opportunities
- Ability 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
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
