Senior Clinical Market Pharmacist

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.  

The Senior Clinical Pharmacist serves as a subject matter expert for the Part D Stars measures as well as other medication related issues including navigating the pharmacy benefit. This role will foster and manage relationships with internal and external partners to produce positive health outcomes and solid star performance for the plan. 

Work Schedule (40 hrs./week): Monday – Friday 8am – 5pm local time with flexibility based on travel requirements

There will be local, state, and national travel up to 25%25 of the time based on business needs.

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

Primary Responsibilities:

• Positions in this function provide clinical pharmacy advice and guidance on any or all of the following:

  • Quality of care programs including HEDIS and CMS Stars programs

  • Develop and train best practices to improve medication adherence and medication related measure gap closures

  • Interpret pharmacy programs to write clinical guidelines, job aids, and decision trees. Write and collaborate on member/provider collateral materials for pharmacy programs

  • Work on program implementation teams and contribute to business process design and systems set up, trouble shooting and updates

  • Review programs for compliance with state, federal and CMS regulations and recommend remediation. Monitor impending legislation for potential impact on current and future programs

  • Analyze data and prepare management summaries related to work stream results, performance management results, audit results, CMS reporting, and client reporting

  • Perform quality audits, determine performance gaps and root causes, prepare reports and collaborate on remediation

  • Examine, evaluate, and provide recommendations to evolve and enhance clinical pharmacy programs and best practices

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

Required Qualifications:

• High School Diploma/GED

• Current and unrestricted pharmacist licensure in State of residence

• 5+ years of experience working as a Licensed Pharmacist within varied practice settings

• 5+ years of experience and/or knowledge of Medicare Part D, Medicaid, and/or commercial

• 1+ year of experience delivering presentations to large audiences

• Intermediate level of proficiency with navigating MS Office and Windows-based environment

• Ability to travel up to 25%25 of the time

Preferred Qualifications:

• Doctor of Pharmacy (PharmD)

• Residency and/or Board Certification (ie: BCPS, BCACP, BCGP)

• Clinical quality experience (ie: HEDIS, Stars, NCQA)

• Experience with Medicare Advantage

• Experience working closely with and influencing providers

• Experience teaching, training, and presenting accurate clinical information verbally to variety of audiences

Soft Skills:

• Excellent written, verbal and presentation skills

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

For more information on our Internal Job Posting Policy, click here.

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 $112,700 to $193,00  per annum based on full-time employment. We comply with all minimum wage laws as applicable. 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.