Clinical Program Consultant - Remote

 Posted 3 hours ago
     
 $91700 - $163K per year
  
5-10 years experience
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AI Summary

The Clinical Program Consultant will identify and execute affordability opportunities for medical drug benefits across the commercial book of business. They will lead cross-functional collaboration between network and pharmacy teams to implement strategies that ensure predictable unit costs and trends.

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

As the Clinical Program Consultant, Affordability Medical Drug Benefit, you will identify and execute affordability opportunities, and execute strategies to address them, including contracting and affordability program development across the commercial book of business.  Your overarching focus will be on identifying areas of affordability for drugs managed on our medical benefits. This role will engage with network leadership to define contracting/reimbursement standards and strategies, along with process controls, and support their successful implementation, to produce predictable unit cost and trend across our enterprise.  This position will also support clinical UM program implementation and help drive cross-functional collaboration between Network and Pharmacy, because we recognize we are ‘Better Together’. You’ll partner with leadership across our enterprise, including data and analytics, legal and regulatory, clinical, HCE, network management and pharmacy experts.

This position requires a motivated self-starter who has the flexibility and versatility to pivot to adjust to evolving business needs and to lead a team of individuals in the same manner.  This individual will engage with enterprise leadership, presenting and gaining support for affordability strategies. This individual will focus relentlessly on execution and value delivery, balancing speed and quality.  The Associate Director reports to the Director of Medical Benefits, Clinical Strategy within UHC E&I.

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

Primary Responsibilities:

  • Create and drive incremental affordability based on analysis of performance results, opportunity identification, and enterprise business strategies
  • Lead development of affordability program strategies including business requirements, process flows and implementation, in conjunction with legal/regulatory, clinical, operations, technology and other key partners
  • Collaborate with other network/affordability leaders to ensure programs and priorities align across the broader enterprise, avoiding redundancy
  • Own contracting affordability program execution from UHC Pharmacy perspective, managing scope, timelines, and stakeholder expectations, to drive an integrated value proposition for pharmacy trend and spend
  • Translate affordability strategy into tactics the organization can execute against with key milestones, responsibilities, and defined dates
  • Work collaboratively with cross-functional teams including clinical and strategy leaders within UHN, clinical team, operations, program management, technology, legal, Optum MBM, and other internal teams to execute roadmap
  • Establish, analyze and report key metrics to ensure optimal business results and ongoing performance
  • Be able to communicate and educate network on relevant network, pharmacy, and regulatory trends, along with competitor offerings
  • Manage competing priorities and work in a fast-paced environment
  • Learn, navigate and communicate end to end processes

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:

  • 5+ years of experience in pharmacy and/or facility/provider contracting roles, with a focus on affordability management and development/implementation of drug payment strategies
  • 5+ years of health care industry experience
  • 3+ years of experience in strategy implementation and program operations/development process
  • Demonstrated experience presenting strategic and performance level information to large audiences 
  • Demonstrated expertise influencing to drive decision-making
  • Demonstrated expertise analyzing business data and trends to identify new opportunities for business growth and improvement in provider/member experience

Preferred Qualifications:

  • Experience network and/or product/operations teams
  • Excellent verbal and written communication skills including MS Word, Excel, and PowerPoint skills 
  • High attention to detail including ability to manage multiple, competing priorities simultaneously
  • Willingness to roll up your sleeves and do whatever is necessary, owner mentality
  • Demonstrated ability to think strategically and execute methodically
  • Demonstrated solid interpersonal, communication and Excel skills
  • Demonstrated solid analytical, project management and critical thinking skills
  • Demonstrated ability to think creatively and comfort being hands-on in a fast-paced environment


*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 salary for this role will range from $91,700 - $163,700 annually 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.

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