Clinical Program Analyst, Medication Star Clinical Program - Remote
About The Position
The Clinical Program Analyst, Pharmacist, uses data insights to improve, enhance, and develop clinical pharmacy program strategies and roadmaps, with a focus on Medicare Star clinical programs. The role provides data-driven insights and clinical recommendations to improve program outcomes, support Star Ratings elevation, and help ensure compliance with CMS guidance and client satisfaction. It involves strategy development, business-case presentation, program design and launch, and collaboration across internal and external stakeholders in a large, matrixed organization. The position is remote within the United States. Extended work hours may sometimes be required to meet time-sensitive CMS and other regulatory deliverables. The role combines pharmacy subject-matter expertise with program data analysis and strategy development. The analyst evaluates clinical outcomes and program performance, develops client-specific improvement strategies, and supports product development and market opportunities across OptumRx channels. The analyst also develops business cases and roadmaps, coordinates cross-functional execution, manages timelines and dependencies, and presents program findings and recommendations to clients, leadership, and other stakeholders.
Requirements
- PharmD or bachelor's degree in pharmacy.
- Current and unrestricted pharmacist licensure.
- At least 3 years of experience working as a clinical pharmacist.
- At least 3 years of managed care experience and clinical program development or clinical program strategy experience.
- Program strategy management capability.
- Critical-thinking expertise.
- Ability to navigate Outlook and conduct Internet searches.
- Proficiency with Microsoft Excel, Power Query, Power BI, and other Microsoft Office tools in a Windows-based environment.
- Demonstrated ability to collect, analyze, and interpret data to develop business strategies and recommendations.
- Ability to analyze data and communicate findings through storytelling.
- Ability to work remotely in accordance with UnitedHealth Group’s Telecommuter Policy.
- Must pass a drug test before beginning employment.
Nice To Haves
- Master of Business or another advanced healthcare or business degree.
- Experience with Medicare Star clinical programs.
- Experience conducting competitive market intelligence analysis.
- Experience presenting to senior leadership, clients, or external stakeholders.
- Experience with CMS Stars measures and performance strategy.
- PBM experience.
- Pharmacy residency experience.
- Medicare Part D experience.
Responsibilities
- Serve as a clinical subject matter expert on Part D Stars measures and related CMS requirements.
- Analyze clinical outcomes data for annual reporting and identify opportunities for improvement.
- Present clinical program findings to clients and leadership stakeholders.
- Oversee pharmacy projects from inception through completion.
- Research clinical program qualification and outcomes criteria.
- Assess and interpret customer needs and requirements; identify solutions to non-standard requests and problems.
- Collaborate with pharmacists and internal staff to develop strategies tailored to client needs.
- Interpret competitive intelligence, industry and market trends, and customer feedback to devise product-development strategies and plans.
- Develop business cases and cost-benefit analyses to support product-development efforts.
- Translate ideas into strategies, define plans and roadmaps with timelines, and coordinate cross-functional launch and execution.
- Work across departments and teams to design, develop, and deploy new or enhanced programs and services.
- Support definition of business-level requirements for enhancements and new capabilities.
- Support development of market and sales strategies and value propositions.
- Navigate and influence cross-functional teams in a complex, matrixed work environment across Optum and UHG business units as needed.
- Adapt departmental plans and priorities to address business and operational challenges.
- Analyze data and prepare management summaries covering work-stream results, performance management, audit results, CMS reporting, and client reporting.
- Support client-specific strategies and project plans for metric improvement.
- Lead client interactions, including presenting program performance, strategy, and recommendations.
- Drive program performance against key metrics such as PDC improvement and Star Ratings, and identify continuous-improvement opportunities.
- Manage timelines, deliverables, and dependencies for CMS submission requirements and client commitments.
- Develop and present executive-level business cases, including PowerPoint presentations and supporting analyses, to senior leadership and clients.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
