Clinical Preferred Drug List Pharmacist

UnitedHealth Group • Nashville, TN

284d • $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. This particular position is for the State of Tennessee Department of Finance and Administration Division of Health Care Finance and Administration Bureau of TennCare Request for Proposals for Pharmacy Benefit Management. The Clinical Preferred Drug List (PDL) Pharmacist will be dedicated to the Health Care Finance and Administration's (HCFA) Medicaid Programs, TennCare, CoverRx and CoverKids.

Requirements

• BS degree in Pharmacy or PharmD.
• Current and unrestricted Pharmacist license in the state of Tennessee.
• 3+ years of experience working as a licensed Pharmacist OR Pharmacy Residency equivalent.
• Client-facing (beyond patients and prescribers) or clinical account management experience.
• Experience with Pharmacy Advisory Committees, DURB (Drug Utilization Review Board) and/or P&T Committees OR Fee For Service Medicaid or Medicaid Managed Care experience.
• Formal presentations experience.
• Proficiency in Microsoft Word, Excel and Outlook.
• Primary residents within a commutable distance to Nashville, TN.

Nice To Haves

• PharmD.
• PBM experience.
• PBM Implementation experience.
• Clinical analytical skills.

Responsibilities

• Support the management and coordination of all activities related to the maintenance of the TennCare PDL.
• Present to the TennCare Pharmacy Advisory Committee.
• Conduct clinical reviews of new brand-name drugs and new generic drugs for clinical safety and efficacy, and make recommendations regarding possible inclusion in the TennCare PDL.
• Annually review drugs within chosen therapeutic classes in order to affirm or change the recommendations to the State regarding supplemental rebate strategies.
• Review drug criteria and recommend proposed changes for the TennCare PDL based on new clinical and pharmacoeconomic information, if requested by the State.
• Conduct class reviews of all existing therapeutic categories over a time-frame to be co-developed with the State.
• Continually and proactively review all products for changes in cost information, including increases and decreases in federal rebates as they affect the TennCare PDL.
• Manage the PDL timeline from preparing for the TennCare Pharmacy Advisory Committee meeting through follow up implementation.
• Implement changes to PDL, Step Therapy or prior authorization requirements which will include modifications to the POS system and all supporting systems and documents.
• Attend, support and facilitate meetings of the TennCare Pharmacy Advisory Committee (PAC) as necessary to maintain the TennCare PDL.
• Monitor compliance by prescribers and pharmacists with the TennCare PDL, report that information to the State monthly, quarterly, and semiannually, and provide suggestions for improving PDL compliance.

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: Ph.D. or professional degree