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Part of the West Region Medicare and Retirement Clinical Pharmacy team, this position will play an integral role in pharmacy quality performance and Star Ratings. The Market Sr 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 strong star performance for the plan. The position reports to the Regional VP of Clinical Pharmacy.
If you are located in Idaho or Utah, you will have the flexibility to telecommute* as you take on some tough challenges. The position requires 50% travel to MT, NV, ID and UT based on business needs.
- Quality of care programs including HEDIS and CMS Stars programs
- Develop and train on best practices to improve medication adherence and medication related measure gap closures
- Interpret pharmacy programs to write clinical guidelines, job aides, 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 to state, federal and CMS regulations and recommend remediation. Monitor impending legislation for potential impact to current and future programs
- Analyze data and prepare management summaries related to work stream results, performance mgmt. results, audit results, CMS reporting, and client reporting
- Perform quality audits, determine performance gaps and root causes, prepares reports and collaborates 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 direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Current and unrestricted Pharmacist licensure in State of UT or ID
- 5+ years of experience working as a Licensed Pharmacist within varied practice settings (Retail, Inpatient Hospital, Managed Care, Physician Practice)
- Demonstrated knowledge of Medicare Part D
- Ability to navigate MS Office and Windows-based environment
- Ability to travel 50% in MT, UT, ID, and NV
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
- Residency and/or Board Certification (ie: BCPS, BCACP)
- 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
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)
*All Telecommuters 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.
Job Keywords: Licensed Pharmacist, Pharmacist, Medicare Part D, PharmD, Residency, Board Certification, BCPS, BCACP, HEDIS, NCQA, Medicare Advantage, CMS regulations, clinical pharmacy, hospital pharmacy, BCBS, Clinical guidelines, MT, UT, ID, NV, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH