Clinical Pharmacist Utilization ManagementOptum • Los Alamitos, California, United States
Clinical Pharmacist Utilization Management
Optum
- Los Alamitos, California, United States
- Los Alamitos, California, United States
À propos
Completes assigned daily prior authorization case reviews to meet production and performance metrics as determined by the department to maintain compliant timeliness standards Review specialty medication prior authorization requests according to established treatment protocols, clinical criteria/guidelines, regulatory requirements and member benefits to ensure consistent and accurate application of clinical criteria & the determination is made within the defined processing times to meet regulatory requirements Knowledgeable of current and emerging clinical trends Provide internal and external clinical pharmacy subject matter consultation to members, physicians, prescribers, nurses, and pharmacists Proactively identify process improvement opportunities and collaborate with other teams and leaders Assist with user acceptance testing for new clinical programs and system enhancements Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practice specific to specialty pharmacy Research and awareness about drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews Follow all policies and procedures, SOPs related to the job Performs all other related duties/activities as assigned to meet departmental objectives
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 (PharmD) Current unrestricted Pharmacist license to practice in CA 3+ years of experience as a Prior Authorization Pharmacist or Clinical Pharmacist, conducting such activities as medication therapy management, clinical rounds, disease state management Experience working in a metric-driven environment Proven excellent written and verbal communication skills Proven excellent relationship building skills Proven solid analytical and PC operation skills Proficiency in Microsoft Office Tools (Outlook, One Note, Teams, Word, Excel, etc) Access to High-Speed Internet and a designated, distraction free workplace
Preferred Qualifications:
Board certification by the Board of Pharmacy Specialties (BPS) Pharmacy Benefit Management Certified Geriatric Pharmacist 1+ years of experience in Oncology Setting Proven knowledge of Medicare, Medicaid, and commercial payor guidelines Demonstrated planning and organizational skills to demonstrate leadership and initiative
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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.
Compétences linguistiques
- English
Avis aux utilisateurs
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