Clinical Program Manager, Medication Therapy Management - National Remote
About The Position
As a Clinical Program Manager, Pharmacist you will lead, maintain, and enhance clinical pharmacy programs. This is your opportunity to join a pharmacy team with a focus on clinical strategy, business impact, and cross-functional collaboration. You will find an incredible team culture that provides opportunities to learn and evolve every day. In this role you will also provide leadership in the development and management of clinical programs. You will be empowered to do your best to develop the strategy and vision for product roadmaps, establish collaborative relationships with external and internal stakeholders, gather accurate requirements and evaluate product performance to enhance our mission of helping people live healthier lives. As a part of the Clinical Programs team, the Clinical Program Manager, Pharmacist is responsible for the strategy, business case presentation, design, development, and launch of new programs, program enhancements, and / or market opportunities that cut across all channels that OptumRx serves. Role will also be responsible for managing the Medication Therapy Management (MTM) program and ensures compliance with CMS MTM programs and satisfaction of clients. Given time - sensitive issues required by CMS and other regulatory bodies, there may be times when extended work hours are required to ensure deliverables are met in a timely manner.
Requirements
- PharmD or Bachelor’s degree in pharmacy
- Current and unrestricted pharmacist licensure
- 3+ years of experience working as a clinical pharmacist
- 3+ years of Managed Care experience OR Clinical Program Development/Clinical Program Management experience
- Beginner level of knowledge to navigate and use for analysis: Microsoft Excel proficiently and other MS Office tools with Windows based environment
- Beginner level of knowledge to collect, analyze, and interpret data to develop business strategies and recommendations.
- Beginner level of knowledge to navigate Outlook and conduct Internet searches
Nice To Haves
- Critical thinking expertise
- Managed Care experience
- Experience with Medication Therapy Management (MTM)
- PBM experience
- Pharmacy residency experience
- Medicare Part D experience
- Experience conducting competitive market intelligence analysis
- Experience presenting to senior leadership, clients, or external stakeholders
- Experience with CMS Stars measures and performance strategy
- Master of Business or other advanced business degree
Responsibilities
- Serve as a clinical subject matter expert (SME) for MTM, Part D Stars, and related CMS requirements
- Clinical analysis of outcomes data for yearly reporting
- Present clinical program findings before National Pharmacy & Therapeutics (P&T) committee
- Oversee pharmacy projects from inception to completion
- Research clinical program qualification and outcomes criteria
- Assess and interpret customer needs and requirements
- Identify solutions to non-standard requests and problems
- Coach, provide feedback and guide others, acts as a resource for others with less experience
- Work with other pharmacists and internally to clinical program adoption
- Ability to interpret competitive intelligence, industry and market trends, and customer feedback and devise strategies and plans for product development opportunities
- Adapt at developing sound development business cases and cost / benefit analyses to support product development efforts
- Ability to translate ideas into strategies, define plan for those strategies, and work cross-functionally to launch and execute on product development plans – with defined roadmap with timelines
- Work directly across many departments and cross functional teams to design, develop and drive successful deployment of new and enhanced programs and services
- Support defining business-level requirements for enhancements and net-new capabilities
- Support the development of market and sales strategies and value proposition
- Navigate and influence multiple cross - functional teams in a complex, matrix work environment, which may require working across Optum and UHG business units
- Adapt departmental plans and priorities to address business and operational challenges
- Analyze data and prepare management summaries related to work stream results, performance management, results, 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 (e.g., CMR completion, Star Ratings) and identify opportunities for continuous improvement
- Manage timelines, deliverables, and dependencies to support 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
- a 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
