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 Performance Quality (CPQ) Director of Clinical Pharmacy (Market Support) supports Optum’s Care Delivery Organizations by supporting CDO markets and patient engagement teams. They will be accountability for, but not limited to: targeted clinical and non-clinical interventions to address specific STARS/HEDIS measures, e.g. medication adherence, care for older adults, statins in persons with diabetes or cardiovascular disease, medication therapy management. In addition, this role will serve as the measure owner for various medication related STARs/HEDIS measures, inclusive of care for older adults, medication adherence, and medication therapy management, statins in persons with diabetes or cardiovascular disease.
This position will work with various functional teams across the matrixed organization: Clinical Service Delivery, Provider offices, Clinical Audit Team, Marketing, Project Management, Finance, Human Capital, and Contract Performance Management
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Own end-to-end management of all quality clinical programs and services
- Identify and resolve organizational challenges across a matrix
- Identify opportunities to improve quality metrics performance while reducing costs
- Develop individualized strategy based on market trends and performance
- Develop and maintain program summaries and portfolio including market facing tools and strategy documents
- Anticipate and respond to questions related to clinical program summaries, processes, or recommendations
- Evaluate clinical or other programs and summarize results for others to client review and possible publication
- Own pharmacy related inquiries and all other client, market and provider inquiries into central quality clinical team:
- Respond to client requests to develop a program to improve clinical outcomes
- Recommend changes to processes based on research in response to internal or external requests
- Provide services to educate providers, clinic groups and CDOs
- Respond to inquiries or complaints from customers or members of the business community and effectively present information to top management and/or external constituents
- Present accurate clinical information verbally to clinical and business leaders
- Oversee the measure owner role, who will interface with market, clients, clinical performance, technology, data and reporting teams as Pharmacy measure owner and subject matter expert
- Serves as a clinical resource and consultant in the areas of pharmacy and medication therapy management
- Develops and implements clinical strategies and quality initiatives as needed to develop and support the business
- Partners with clinical leadership to act as a SME for reporting needs across platforms and systems used by the pharmacy team
- Communicate effectively with internal and external clients and key stakeholders to keep them informed of pharmacy programs and initiatives
- Identify and utilize appropriate systems to retrieve clinical data for analyses
- Serve as a leader/partner across the organization focused on delivering the highest levels of performance for our clients
- Completes other duties as assigned
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
- Active, unrestricted pharmacy license
- 5+ years of Clinical Pharmacy Practice experience
- 3+ years of experience with Medicare STARs & HEDIS Measures, inclusive of Medication Adherence, Medication Therapy Management (MTM)
- 1+ years of experience developing programs and services to be delivered in a clinical call center with in-bound and out-bound capabilities
- Experienced using Microsoft office applications, including databases, word-processing, outlook, and excel spreadsheets. Must be proficient in Excel
- Ability to manage multiple complex, concurrent projects
- Excellent written and verbal communication and relationship building skills
- Planning and organizational skills to demonstrate leadership and initiative
- Solid interpersonal skills
- Ability to work independently, as well as a member of a team
- Ability to travel up to 25%
Preferred Qualifications:
- MBA/MPH Degree
- 2+ years of client and key stakeholder communications experience with an emphasis on performance reporting
- Campaign Management experience
- Exceptional interpersonal skills with ability to interface effectively with all levels of the organization, as well as externally with clients
Physical & Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
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–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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law 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, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.