Clinical Pharmacist Utilization Management - Remote PST
: Job Details :

Clinical Pharmacist Opportunity

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you will 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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Unique opportunity for a clinical pharmacist to improve patient care and outcomes through completion of utilization management functions for value-based patients in the Optum West region. This is a full-time position with variable hours between 7:00 am to 6:00 pm MST or PST, Monday - Friday (Five 8-hour days). Rotating weekend coverage. 100% telecommuter position.

Under general supervision of the Pharmacy Manager, the Clinical Pharmacist is responsible for evaluating medication utilization and prior authorization requests for specialty oncology and non-oncology ambulatory injectable and/or infusion medications as related to member benefits, medical necessity, site of service, and evidence based clinical guidelines.

Primary Responsibilities:

• Completes assigned daily prior authorization case reviews to meet production and performance metrics.
• Review specialty medication prior authorization requests according to established treatment protocols, clinical criteria/guidelines, regulatory requirements.
• Provide internal and external clinical pharmacy subject matter consultation.
• Proactively identify process improvement opportunities.
• Assist with user acceptance testing for new clinical programs and system enhancements.
• Ensure and evaluate quality controls and implement opportunities for performance improvement.
• Research and awareness about drug information.
• Follow all policies and procedures, SOPs related to the job.

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:

• Doctor of Pharmacy degree (PharmD)
• Current unrestricted Pharmacist license to practice in AZ, CA, NM, NV, UT, ID, WA or OR
• 3+ years of experience as a Prior Authorization Pharmacist or Clinical Pharmacist

Preferred Qualifications:

• Board certification by the Board of Pharmacy Specialties (BPS)
• 1+ years of experience in Oncology Setting
• Certified Geriatric Pharmacist
• Proven knowledge of Medicare, Medicaid, and commercial payor guidelines

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). The salary for this role will range from $89,900 to $160,600 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 deserves the opportunity to live their healthiest life. UnitedHealth Group is an Equal Employment Opportunity employer 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.