Clinical Preferred Drug List Pharmacist - Remote in TN

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.

This particular position is for the:

State of Tennessee
Department of Finance and Administration
Division of Health Care Finance and Administration
Bureau of TennCare
Request for Proposals for Pharmacy Benefit Management

The Clinical Preferred Drug List (PDL) Pharmacist will be dedicated to the Health Care Finance and Administration's (HCFA) Medicaid Programs, TennCare, CoverRx and CoverKids.

The Clinical Preferred Drug List Pharmacist shall be licensed by the State of Tennessee Board of Pharmacy and whose duties shall include, but are not limited to, all aspects of the TennCare Preferred Drug List and processes and will perform similar duties for the CoverRx and CoverKids Programs. The Clinical PDL Pharmacist shall be readily available to HCFA staff during regular working hours and shall be one hundred percent (100%) dedicated to the HCFA Programs, with approximately ninety five percent (95%) of their time devoted to the TennCare Program and the remaining five percent (5%) split between
the CoverRx and CoverKids Programs, on an as needed basis.

If you are located within a commutable distance to Nashville, TN, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:
The Pharmacist shall support the management and coordination of all activities related to the maintenance of the TennCare PDL. Activities shall include but not be limited to the following:

• Present to the TennCare Pharmacy Advisory Committee
• Conduct clinical reviews of new brand-name drugs and new generic drugs for clinical safety and efficacy, and make recommendations regarding possible inclusion in the TennCare PDL, Authorization criteria for coverage and appropriate quantity limits where applicable
• Annually review drugs within chosen therapeutic classes in order to affirm or change the recommendations to the State regarding supplemental rebate strategies
• Review drug criteria and recommend proposed changes for the TennCare PDL based on new clinical and pharmacoeconomic information, if requested by the State
• Conduct class reviews of all existing therapeutic categories over a time-frame to be codeveloped with the State
• Continually and proactively review all products for changes in cost information, including increases and decreases in federal rebates as they affect the TennCare PDL
• Manage the PDL timeline from preparing for the TennCare Pharmacy Advisory Committee meeting through follow up implementation. This timeline shall be co-developed with the State
• Implement changes to PDL, Step Therapy or prior authorization requirements which will include modifications to the POS system and all supporting systems and documents
• Attend, support and facilitate meetings of the TennCare Pharmacy Advisory Committee (PAC) as necessary to maintain the TennCare PDL. Such support shall include the responsibility to develop drug class reviews, prior authorization criteria, quantity limits and step therapy recommendations
• Present to the TennCare Pharmacy Advisory Committee drug class reviews for new or existing drugs and new indications that might affect their inclusion in the TennCare PDL
• Monitor compliance by prescribers and pharmacists with the TennCare PDL, report that information to the State monthly, quarterly, and semiannually, and provide suggestions for improving PDL compliance

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:

• BS degree in Pharmacy or PharmD
• Current and unrestricted Pharmacist license in the state of Tennessee
• 3+ years of experience working as a licensed Pharmacist OR Pharmacy Residency equivalent
• Client-facing (beyond patients and prescribers) or clinical account management experience
• Experience with Pharmacy Advisory Committees, DURB (Drug Utilization Review Board) and/or P&T Committees OR Fee For Service Medicaid or Medicaid Managed Care experience
• Formal presentations experience
• Proficiency in Microsoft Word, Excel and Outlook
• Primary residents within a commutable distance to Nashville, TN

Preferred Qualifications:

• PharmD
• PBM experience
• PBM Implementation experience
• Clinical analytical skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $89,800 to $176,700 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.

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.