1+ months

Health Plan Pharmacist - Louisville, KY or Telecommute

Louisville, KY 40202 Work Remotely
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Here you'll find a professional culture where you can use your talent and our resources to make an impact on a huge scale. You'll open doors for yourself that simply do not exist in any other organization, anywhere. Take this opportunity to start doing your life's best work.(sm)

As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm)

The Account Manager Pharmacist role serves as the primary point of contact to the Pharmacy Management program for the Community Plan health plan management team related to execution of the pharmacy benefit program. In this role you will be accountable to be the primary point of contact to manage the ongoing contract relationship, conduct pharmacy benefit analysis to support the provision of clinically appropriate, high quality, cost effective pharmaceutical care for Health plan members.

This position is an integral part of the UnitedHealthcare Pharmacy team, reporting to the Regional Pharmacy Director for Plan Management.

If you are located within commutable distance from Louisville, KY, you will have the flexibility to telecommute* as you take on some tough challenges. 

Primary Responsibilities:
  • Build and maintain client relationships and serve as the primary point of contact for overall and day-to-day service with local UHC plan
  • Build strong working relationships with Plan CEO, COO, CFO, and Medical Director
  • Assist plan on all pharmacy related activities including clinical program development and improving member satisfaction
  • Responsible for understanding and assuring compliance with the state contract and the rules governing pharmacy (formulary/PDL, UM, member communications, etc.)
  • Accountable for creation and maintenance of state specific polices
  • Service as the SME SPOC for benefit and coding requirements and responsible for communication to appropriate internal stakeholders for implementation
  • Develop a strong working knowledge of health plan operations (compliance, finance, encounters, claims adjudications, networks, clinical, case management, HEDIS measures, etc.)
  • Collaborate with internal partners to complete projects and to address on-going pharmacy service needs of the plan
  • Analyze, review, forecast, trend, and present information for operational and business planning
  • Communicate pharmacy program changes with the assigned health plans key departments
  • Support Plan short and long term operational/strategic business activities by maintaining operational information
  • Attend State Medicaid meetings and build relationship with the State pharmacy team
  • Attend state pharmacy and health plan association meeting and build relationships
  • Responsible for the timely submission of accurate pharmacy reports and deliverables
  • Support the assigned health plans Grievances Department in the processing of grievances, appeals, fair hearings, etc., as defined by the health plans process to ensure a timely decision by the plan Medical Director
  • Support assigned health plans Health Services, Case Management and Behavioral Health areas regarding targeted members with specific pharmacy concerns

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.

Jobs Rated Reports for Pharmacist

Posted: 2020-09-18 Expires: 2020-11-19

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Health Plan Pharmacist - Louisville, KY or Telecommute

UnitedHealth Group
Louisville, KY 40202

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33rd2018 - Pharmacist
Overall Rating: 33/220
Median Salary: $124,170

Work Environment
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