Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

This position will assist the VP, Government Programs Formulary Strategy with identifying competitive OptumRx Medicare and Exchange formulary and trend management strategies to manage pharmacy spend and clinical quality. This position is responsible for implementing proactive, comprehensive cost-management strategies to protect clients from undo financial exposure related to high-cost medications. This position will also provide sales support activity related to formulary and trend management and support Clinical Consulting.

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

Primary Responsibilities:

• Research upcoming drug releases and treatment guidelines, and coordinate with the Director to develop recommendations for formulary modifications. May also include presenting at Pharmacy & Therapeutics Committee
• Monitoring the competitive marketplace to serve as subject matter expert on our OptumRx Formulary offerings and how they compare and perform versus major competitors
• Provide strategic direction for the OptumRx Medicare Part D formularies to be compliant with CMS formulary guidance
• Provide strategic direction for the OptumRx Exchange formulary to be compliant with ACA legislation and competitive on the health insurance marketplace
• Work closely with Sales, Pre-Sales Analytics, Marketing, Industry Relations, Clinical Consulting, Client Management and Pricing teams to define formulary and trend management parameters, develop strategies to address client issues and achieve maximum impact on sales and contract renewals
• Review CMS Quarterly Trend memos and evaluate utilization data to identify drugs with potentially fraudulent impact
• Work with Clinical Analytics and others to develop clear and effective prospective analytics, outcomes reporting, value proposition and product story to demonstrate value to prospective clients
• Serve as a liaison between the Clinical Services team and other cross-functional areas, including Industry Relations, Formulary Operations, Clinical Analytics, and Sales (Clinical Consultants; Account Management; Sales Team) to gain clear and up-to-date understanding of changing marketplace needs relative to formulary-related strategies
• Assist departmental leadership with educating all key stakeholders regarding new formulary / trend management activities and routine refinements to existing offerings
• Ensure that enhancement and new initiatives are clinically sound, financially appropriate for both the Company and its customers, and meet or exceed customer goals
• Assist in the management of the entire life cycle from strategic planning to tactical activities through hand off to the operations team
  

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:

• B.S. in Pharmacy or PharmD degree
• Active, unrestricted pharmacist license
• 3+ years of managed care pharmacy experience with emphasis on Medicare Part D and/or Exchange formulary management
• 3+ years of extensive involvement in managed healthcare clinical pharmacy strategy
• 3+ years hands-on experience in formulary management
• Proficiency in Microsoft Word, Excel, PowerPoint, Outlook
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• Doctor of Pharmacy degree
• Demonstrated clinical and analytic skills and background
• 5+ years of managed care pharmacy experience with emphasis on Medicare Part D and/or Exchange formulary management
• 5+ years of extensive involvement in managed healthcare clinical pharmacy strategy
• 5+ years hands-on experience in formulary management
• Ability to conceptualize, align and explain strategic vision based upon multiple complex parameters, including healthcare marketplace, market trends, competitor products, emerging technologies, business opportunities, company goals, client and consultant requests, product value, product development capabilities and product development process
• Sound understanding of formularies across different lines of business (e.g., Medicare Part D, exchanges) and marketplace needs
• Ability to think externally and strategically
• Demonstrated experience working with all levels of cross-functional teams (executives, managers, analysts)
• Excellent communication, presentation, and interpersonal skills
• Ability to make judgments about the value of ideas, needs and resources, and to effectively communicate the advantages and disadvantages of each to other decision makers
• In-depth knowledge of the healthcare industry from both clinical and business perspectives
• Ability to manage multiple projects simultaneously
• Creative, high-energy self-starter with broad background, creative drive, and innovative solutions to business needs
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

Colorado, Connecticut, Nevada, or New York City Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut/Nevada/New York City residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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