Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Clinical Program Manager, Pharmacist will lead and enhance clinical pharmacy programs, develop strategies for product roadmaps, and manage the Medication Therapy Management program while ensuring compliance with CMS requirements.
Responsibilities
- Serve as a clinical subject matter expert (SME) for MTM, Part D Stars, and related CMS requirements
- Clinical analysis of outcomes data for yearly reporting
- Present clinical program findings before National Pharmacy & Therapeutics (P&T) committee
- Oversee pharmacy projects from inception to completion
- Research clinical program qualification and outcomes criteria
- Assess and interpret customer needs and requirements
- Identify solutions to non-standard requests and problems
- Coach, provide feedback and guide others, acts as a resource for others with less experience
- Work with other pharmacists and internally to clinical program adoption
- Ability to interpret competitive intelligence, industry and market trends, and customer feedback and devise strategies and plans for product development opportunities
- Adapt at developing sound development business cases and cost / benefit analyses to support product development efforts
- Ability to translate ideas into strategies, define plan for those strategies, and work cross-functionally to launch and execute on product development plans - with defined roadmap with timelines
- Work directly across many departments and cross functional teams to design, develop and drive successful deployment of new and enhanced programs and services
- Support defining business-level requirements for enhancements and net-new capabilities
- Support the development of market and sales strategies and value proposition
- Navigate and influence multiple cross - functional teams in a complex, matrix work environment, which may require working across Optum and UHG business units
- Adapt departmental plans and priorities to address business and operational challenges
- Analyze data and prepare management summaries related to work stream results, performance management, results, audit results, CMS reporting, and client reporting
- Support client-specific strategies, and project plans for metric improvement
- Lead client interactions, including presenting program performance, strategy, and recommendations
- Drive program performance against key metrics (e.g., CMR completion, Star Ratings) and identify opportunities for continuous improvement
- Manage timelines, deliverables, and dependencies to support CMS submission requirements and client commitments
- Develop and present executive-level business cases, including PowerPoint presentations and supporting analyses, to senior leadership and clients
Skills
- PharmD or Bachelor's degree in pharmacy
- Current and unrestricted pharmacist licensure
- 3+ years of experience working as a clinical pharmacist
- 3+ years of Managed Care experience OR Clinical Program Development/Clinical Program Management experience
- Beginner level of knowledge to navigate and use for analysis: Microsoft Excel proficiently and other MS Office tools with Windows based environment
- Beginner level of knowledge to collect, analyze, and interpret data to develop business strategies and recommendations
- Beginner level of knowledge to navigate Outlook and conduct Internet searches
- Critical thinking expertise
- Managed Care experience
- Experience with Medication Therapy Management (MTM)
- PBM experience
- Pharmacy residency experience
- Medicare Part D experience
- Experience conducting competitive market intelligence analysis
- Experience presenting to senior leadership, clients, or external stakeholders
- Experience with CMS Stars measures and performance strategy
- Master of Business or other advanced business degree
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
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