Job Description

OptumRx, a UnitedHealth Group company, with over 28,000 employees globally, specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. Our goal is to deliver high-quality, integrated services to promote optimal outcomes, superior savings and outstanding client and consumer experiences. We make healthier happen by creating smarter health care connections to help more than 65 million consumers nationwide realize improved care, lower costs and a better overall experience. Leveraging expertise, flexible technology and a network of over 67,000 community pharmacies, and the use of our own state-of-the-art specialty and home delivery pharmacies and fulfillment centers, we are driving value to those we serve through our transforming capabilities. This is a place like no other and where you'll do your life's best work.(sm)

Clinical Prior Authorization Pharmacist

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

* Research and interpret peer-reviewed data, treatment guidelines and clinical trials to develop and maintain Specialty prior authorization criteria, job aides, and decision trees
* Analyze data, solve complex problems and prepare payer summaries for reporting
* Perform quality audits, determine performance gaps and root causes, prepare reports and collaborate on remediation
* Present business reports and quality reviews to payers and internal stakeholders
* Oversee day-to-day operations while managing payers' needs
* Coordinate with internal stakeholders to market PA Navigator services-Serve as a resource to others
* Assess and interpret payers needs and requirements
* Work with minimal guidance; seeks guidance on only the most complex tasks
* Translate concepts into practice
* Provide explanations and information to others on difficult issues
* Coach, provide feedback, and guide others

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:

* Bachelor of Science in Pharmacy (BSPharm)
* Active Pharmacy License
* 3+ years Clinical Pharmacist experience
* Data analysis and medical literature review
* 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 a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

* Prior Authorization experience
* Criteria development experience
* Doctor of Pharmacy (PharmD)
* Board Certified Pharmacist
* Solid communication and presentation skills

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*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: Prior Authorization, Pharmacist, Clinical Pharmacist, Specialty, Home Infusion, RX, Prescription, Payers, healthcare