Clinical Program Pharmacist Analyst, Medication Star Clinical Program - Remote

UnitedHealth Group; Schaumburg (IL); Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Remote work policy

Job summary

UnitedHealth Group seeks a Clinical Program Analyst, Pharmacist, to transform data insights into actionable clinical pharmacy strategies and roadmaps. You will influence CMS Stars measures, develop business cases, and collaborate across a large matrixed organization to improve Medicare Star programs.

The role emphasizes cross-functional teamwork, stakeholder engagement, and delivering timely, data-driven recommendations while supporting CMS submission requirements in a remote, national capacity.

Qualifications

• PharmD or bachelor's degree in pharmacy must be completed.
• Current and unrestricted pharmacist licensure is required.
• 3+ years of experience working as a clinical pharmacist.
• 3+ years of Managed Care experience AND Clinical Program Development/Clinical Program Strategy experience.
• Strong skills in data analysis, Excel, and interpretation of CMS guidelines.

Responsibilities

• Serve as SME for Part D Stars measures impacting the program and CMS requirements.
• Analyze outcomes data for yearly reporting and improvement opportunities.
• Present clinical program findings to clients and leadership stakeholders.
• Oversee pharmacy projects from inception to completion.
• Develop and present executive-level business cases and analyses.
• Lead client interactions and drive program performance improvements.

Skills

Pharmacist licensure

Clinical pharmacist

Managed Care experience

Program Strategy Management

Critical thinking

Data analysis

Storytelling with data

Outlook proficiency

Excel

Power BI

Power Query

MS Office

Education

PharmD or Bachelor's degree in Pharmacy

Tools

Microsoft Excel

Power BI

Power Query

Job description

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI whileCaring. Connecting. Growing together.

As a Clinical Program Analyst, Pharmacist, you will use data insights to improve, enhance, and create strategies and roadmaps for clinical pharmacy programs. This is your opportunity to join a pharmacy team with a focus on clinical strategy, business impact, and cross-functional collaboration. You will find an incredible team culture that provides opportunities to learn and evolve every day.

In this role you will provide data-driven insights aggregated into clinical recommendations driving incremental improvement of Medicare Star clinical programs. You will be empowered to do your best to develop the strategy and vision for product roadmaps, establish collaborative relationships with external and internal stakeholders, gather accurate requirements and evaluate product performance to enhance our mission of helping people live healthier lives.

As a part of the Clinical Programs team, the Clinical Program Analyst Pharmacist is responsible for strategy, business case presentation, design, development, and launch of strategies, initiatives, program enhancements, and / or market opportunities that cut across all channels that OptumRx serves. Role will include cross-collaboration with a large matrixed environment, requiring developing rapport, relationships and trust. Stars program ensures compliance with CMS guidance of programs and satisfaction of clients warranting movement of the needle in terms of Stars Rating Elevation. Given time - sensitive issues required by CMS and other regulatory bodies, there may be times when extended work hours are required to ensure deliverables are met in a timely manner.

This position is remote.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Primary Responsibilities include both pharmacy (15%) and program data analysis and Strategy Development (85%)

• Pharmacy:
  • Serve as a clinical subject matter expert (SME) for, Part D Stars Measures impacting the program, and related CMS requirements
  • Clinical analysis of outcomes data for yearly reporting and improvement opportunities
  • Present clinical program findings to clients and leadership stakeholders
  • Oversee pharmacy projects from inception to completion
  • Research clinical program qualification and outcomes criteria
  • Assess and interpret customer needs and requirements
  • Identify solutions to non-standard requests and problems
  • Work with other pharmacists and internal staff to create dedicated strategy tailored to client needs
• Program Analysis and Strategy:
  • Ability to interpret competitive intelligence, industry and market trends, and customer feedback and devise strategies and plans for product development opportunities
  • Adept at developing sound development business cases and cost / benefit analyses to support product development efforts
  • Ability to translate ideas into strategies, define plan for those strategies, and work cross-functionally to launch and execute on product development plans - with defined roadmap with timelines
  • Work directly across many departments and cross functional teams to design, develop and drive successful deployment of new and enhanced programs and services
  • Support defining business-level requirements for enhancements and net-new capabilities
  • Support the development of market and sales strategies and value proposition
  • Navigate and influence multiple cross - functional teams in a complex, matrixed work environment, which may require working across Optum and UHG business units
  • Adapt departmental plans and priorities to address business and operational challenges
  • Analyze data and prepare management summaries related to work stream results, performance management, results, audit results, CMS reporting, and client reporting
  • Support client-specific strategies, and project plans for metric improvement.
  • Lead client interactions, including presenting program performance, strategy, and recommendations
  • Drive program performance against key metrics (e.g., PDC improvement, Star Ratings) and identify opportunities for continuous improvement
  • Manage timelines, deliverables, and dependencies to support CMS submission requirements and client commitments
  • Develop and present executive-level business cases, including PowerPoint presentations and supporting analyses, to senior leadership and clients

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:

• PharmD or bachelor's degree in pharmacy
• Current and unrestricted pharmacist licensure
• 3+ years of experience working as a clinical pharmacist
• 3+ years of Managed Care experience AND Clinical Program Development/Clinical Program Strategy experience
• Program Strategy Management
• Critical thinking expertise
• Ability to navigate Outlook and conduct Internet searches
• Ability to navigate and use for analysis: Microsoft Excel proficiently, Power Query, Power BI, and other MS Office tools with Windows based environment
• Demonstrated ability to collect, analyze, and interpret data to develop business strategies and recommendations
• Adept at analysis of data and storytelling

Preferred Qualifications:

• Master of Business or other advanced healthcare or business degree
• Experience with Medicare Star Clinical Programs
• Experience conducting competitive market intelligence analysis
• Experience presenting to senior leadership, clients, or external stakeholders
• Experience with CMS Stars measures and performance strategy
• PBM experience
• Pharmacy residency experience
• Medicare Part D experience

*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 - $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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.