Clinical Pharmacist - Sugar Land, TX

The Local Market Clinical Pharmacist is responsible for engaging our plan members, network providers and local pharmacies in discussions related to Part D quality measures and programs primarily for our Medicare and Retirement business.  Performance management is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and improved quality.  The person in this role is expected to work directly with our members, providers and pharmacies to build relationships, ensure effective education. They will proactively identify performance improvement opportunities through data analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results.
 
 
 
 
Primary Responsibilities:

Strategic thinker, functioning independently, communicate across assigned territory (telephonically / travel) to communicate with members, providers and pharmacies to discuss Optum and UHC tools and programs focused on improving the quality of care for Medicare Advantage Members specifically focusing on medication adherence and other Part D pharmacy clinical measures
Engage with members to address health literacy deficiencies
Partner with cross-functional areas and Pharmacy STAR team to perform integrated servicing to effectively address medication adherence deficiencies
Engage and collaborate with pharmacies; including the independent pharmacies across the state, to improve medication adherence of Medicare Advantage Members
Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
Develop comprehensive, provider-specific plans to increase their HEDIS and Part D performance and improve their outcomes
Provide ongoing strategic recommendations, training and coaching to provider groups and pharmacies on program implementation and barrier resolution
Driving strategies such as medication synchronization, MTM and incentive programs
Engage and coordinate necessary internal resources together (PPM) in order to provide appropriate, effective provider education, coaching and consultation; training will include Stars measures (HEDIS / CAHPS / HOS / med adherence), M&R Pharmacy STARs administration, and use of plan tools, reports and systems
Provide reporting to health plan leadership on progress of overall performance of pharmacy measures, gap closure, and use of virtual administrative resource
Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation - may be to Sr Leadership
Provide suggestions and feedback to M&R Pharmacy STARs, and health plan regarding Medication Adherence Strategies
Provide clinical knowledge to our providers of chronic disease states in particular diabetes, hypertension and hyperlipidemia and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
Deliver high quality evidence-based therapeutic recommendations to providers and members
Work collaboratively with health plan market leads to make providers aware of Plan-sponsored initiatives designed to assist and empower members in closing gaps
Accountability to driving H-Contract to 4 Star goal
Role may include up to 25% local travel 

Primary Responsibilities:

Strategic thinker, functioning independently, communicate across assigned territory (telephonically / travel) to communicate with members, providers and pharmacies to discuss Optum and UHC tools and programs focused on improving the quality of care for Medicare Advantage Members specifically focusing on medication adherence and other Part D pharmacy clinical measures
Engage with members to address health literacy deficiencies
Partner with cross-functional areas and Pharmacy STAR team to perform integrated servicing to effectively address medication adherence deficiencies
Engage and collaborate with pharmacies; including the independent pharmacies across the state, to improve medication adherence of Medicare Advantage Members
Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
Develop comprehensive, provider-specific plans to increase their HEDIS and Part D performance and improve their outcomes
Provide ongoing strategic recommendations, training and coaching to provider groups and pharmacies on program implementation and barrier resolution
Driving strategies such as medication synchronization, MTM and incentive programs
Engage and coordinate necessary internal resources together (PPM) in order to provide appropriate, effective provider education, coaching and consultation; training will include Stars measures (HEDIS / CAHPS / HOS / med adherence), M&R Pharmacy STARs administration, and use of plan tools, reports and systems
Provide reporting to health plan leadership on progress of overall performance of pharmacy measures, gap closure, and use of virtual administrative resource
Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation - may be to Sr Leadership
Provide suggestions and feedback to M&R Pharmacy STARs, and health plan regarding Medication Adherence Strategies
Provide clinical knowledge to our providers of chronic disease states in particular diabetes, hypertension and hyperlipidemia and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
Deliver high quality evidence-based therapeutic recommendations to providers and members
Work collaboratively with health plan market leads to make providers aware of Plan-sponsored initiatives designed to assist and empower members in closing gaps
Accountability to driving H-Contract to 4 Star goal
Role may include up to 25% local travel 
Required Qualifications:

Licensed Pharmacist
1+ year of medication adherence counseling experience
3+ years of healthcare experience
1+ year of community pharmacy experience
1+ year of Medicare market experience
Knowledge base of clinical standards of care, preventive health and Stars measures
Preferred Qualifications:

Current New Mexico PharmD license
Strong MTM skills with Outcomes and Mirixa platforms
Experience in managed care working with network and provider relations / contracting
Strong knowledge of electronic medical record systems
Consulting experience
Strong problem-solving skills
Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills
Strong communication and presentation skills
Strong relationship building skills with clinical and non-clinical personnel
Careers with UnitedHealthcare Medicare and Retirement. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Medicare and Retirement brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
 
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: Pharmacist, Stars, PharmD, Performance Manager, Quality Advocate, Quality, Project Management, Consulting, Providers, Member Groups, Contracts, Health Plan, Quality Improvement, Sugar Land, TX, Texas
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