Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Clinical Pharmacist will be responsible for overseeing the pharmacy audit program for UHCP and share findings with key stake holders as they look for opportunities to improve the review process. The person in this role will work collaboratively with UHCP internal partners as well as OptumRx partner teams to ensure clinical programs are implemented accurately, on time based on audit results. The Clinical Pharmacist will also support appropriate pharmacy collateral and strategy and development of pharmacy clinical programs.

*** Candidate must be available to work 10-15 hours per week. ***

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform quality audits, determine performance gaps and root causes, prepare reports and collaborates on remediation
• Use existing technology and validation tools to review prior authorization set up and gain insight into drug specific prior authorization information
• Work on program prior authorization implementation teams and contribute to business process design and systems set up, trouble shooting and updates
• Review programs for compliance regulations and recommend remediation
• Analyze data and prepare management summaries related to work stream results, performance mgmt. results, audit results
• Effectively participates in and contributes to staff meetings and other staff development opportunities and interdepartmental work groups
• Identifies areas of improvement where systems modifications could result in operational advancements and efficiencies
• Other duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Pharmacy degree, and active, unrestricted license to practice as a Pharmacist in the United States
• 3+ years of experience working with Prior Authorization and/or appeals
• 2+ years of experience with E&I Commercial Pharmacy plans

Preferred Qualifications:

• Familiarity with Medispan and GPI coding
• Familiarity with pharmacy auditing
• Proven exposure w/ AI programs

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $44.00 - $79.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Requisition #: 2371261

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Requirements