Clinical Pharmacist

Clinical Pharmacist - Stars Team - Remote

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
 
 
The Clinical Stars Team provides a variety of services including United HealthCare at Home (UAH) strategic Medication Adherence outreach initiatives, Care of Older Adults (COA) medication reviews/health assessments, and MTM consultations. The team also supports APC providers via a clinical consultation service. All services are provided by a team of Clinical Pharmacists, with the support of Pharmacy Technicians, that engage with plan members and their healthcare providers in a telephonic environment.
 
 
The Clinical Pharmacist will report to the Clinical Team Manager (CTM) within the Optum Enterprise Care Services department. The primary responsibility of the Clinical Pharmacist will be to perform clinical consults via telephone with members served by the UAH program and providing services such as optimizing medication therapy, adherence counseling, drug interaction screening, and disease state counseling for diabetes, hypertension, hypercholesterolemia, and much more. The Clinical Pharmacist will be an integral part of a team of Clinicians of varying disciplines and will be expected to meet or exceed established productivity and quality metrics as well as staying engaged throughout the process, helping the department reach yearly goals together as a team.
 
 
If you are located within CST or EST, you will have the flexibility to work remotely* as you take on some tough challenges.
 
Primary Responsibilities:
 
 
* Conduct medication consults with members telephonically that meet/exceed both internal and external quality metrics for UAH, COA, and MTM
 
* Identify and address member specific medication adherence barriers. Collaborate with patient's providers and/or pharmacy to overcome barriers to improve STARs rating
 
* Implementing a health literate member-centric approach within all clinical consults performed
 
* Participating and engaging on a team of other clinicians both in person and virtually
 
* Supports patients in their initiation and maintenance of new therapy, providing education, optimizing utilization, and establishing adherence
 
* Meet or exceed established production metrics on a weekly and monthly basis
 
* Meet or exceed established quality and health literacy metrics on a weekly and monthly basis
 
* Meet or exceed established adherence attributable fill rate
 
* Conducting various additional campaigns throughout the year based on the needs of the business, which will be assigned by the CTM
 
* Provide support to Advanced Practice Clinicians (APC's) in the field via telephonic clinical consultation
 
* Actively participating in coaching sessions to both improve and maintain clinical interaction skills and overall performance
 
 
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:
 
 
* Active, unrestricted pharmacy license in the state you reside
 
* 1+ years Clinical Pharmacy Practice experience
 
* Designated secure workspace and access to install secure high-speed internet via cable/DSL in home
 
 
Preferred Qualifications:
 
 
* MBA/MPH Degree
 
* Post Graduate Training (Pharmacy Residency and/or Fellowship)
 
* Active, unrestricted pharmacy license in one of the states considered as Restricted (AL, ID, KY, LA, MD, OR, TN, VT)
 
* Board certification by the Board of Pharmacy Specialties (BPS)
 
* Certified Geriatric Pharmacist
 
* 1+ years Call Center Experience
 
* Experience with Medication Therapy Management (MTM) &amp; Comprehensive Medication Reviews
 
* Experience with Medicare STARs &amp; HEDIS Measures
 
* Proficient with Microsoft Word, Excel, Outlook, PowerPoint
 
* Bilingual in Spanish, Mandarin, Cantonese, Korean, Russian, or Vietnamese
 
* Proven both written and verbal communication skills to interact with patients and clinic staff
 
* Proven solid interpersonal skills
 
* Proven excellent written and verbal communication and relationship building skills
 
* Demonstrated ability to work independently, as well as a member of a team
 
 
Competencies:
 
 
* Demonstrated record of being a self-starter, with a solid independent work drive
 
* Habitual use of metrics in daily work
 
* Effective communication skills (phone, email, written communication and documentation)
 
* Effective organizational skills
 
* Effective interpersonal skills, ability to establish and build new relationships from scratch
 
 
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
 
 
Connecticut, New York, Rhode Island, or New Jersey Residents Only: The salary range for Connecticut, New York, Rhode Island, or New Jersey residents is $85,000 to $167,300. 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
 
 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
 
 
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.

Clinical Pharmacy Technician Remote in California

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
 
**Job Posting Title**
 
 
Clinical Pharmacy Technician Remote in California
 
 
**Job Description Summary**
 
 
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
 
 
**Job Description**
 
 
+ Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.
 
 
+ Researches, resolves and documents prior authorization outcomes in pharmacy system.
 
 
+ Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
 
 
+ Escalates requests to Pharmacist when request requires extensive clinical review or denial.
 
 
+ Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
 
 
+ Performs other duties as required.
 
 
**Responsibilities**
 
 
+ LPT: Licensure in accordance with California state requirements.
 
 
+ Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
 
 
+ In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
 
 
+ Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
 
 
+ Excellent written and verbal communication skills.
 
 
+ Ability to follow clinical criteria and instructions to approve prior authorization requests.
 
 
+ Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
 
 
+ Ability to identify and trouble-shoot problematic issues.
 
 
**Work Experience**
 
 
Work Experience - Required:
 
 
Pharmacy
 
 
Work Experience - Preferred:
 
 
**Education**
 
 
Education - Required:
 
 
GED, High School
 
 
Education - Preferred:
 
 
**Certifications**
 
 
Certifications - Required:
 
 
LPT - Licensed Pharmacy Technician - Pharmacy - Pharmacy
 
 
Certifications - Preferred:
 
 
Potential pay for this position ranges from $15.29 - $22.93 based on experience and skills. Pay range may vary by 8% depending on applicant location.
 
 
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the &quot;Benefits at a glance&quot; button for more detail.
 
 
_Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law._
 
 
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
 
 
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
 
 
Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ** ** If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

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