Remote Formulary Consulting Group Lead

Optum; Irvine (CA); Remote; USD 113,000 - 193,000; Full time

Job summary

Optum seeks a health-care formulary strategist to support the Formulary Management Services team. You will analyze client formularies, model financial impact, and present recommendations to improve clinical and cost outcomes.

This remote role allows work from anywhere in the U.S. with standard business hours, up to 10% travel. You will collaborate across teams to deliver client-ready materials and drive process improvements.

Qualifications

• Experience in client management or client-facing roles.
• Experience in formulary operations or strategy.
• Experience in clinical operations (P&T, UMs, pipeline) or related areas.

Responsibilities

• Deliver value to clients through formulary strategies and client engagements.
• Evaluate client formularies and contracts; analyze pricing, utilization and spend.
• Develop and present client-facing materials that are clear and actionable.
• Collaborate across teams to meet deadlines and manage deliverables with partners.
• Act as a SME on therapeutic class strategies and drive continuous improvement.
• Travel up to 10% as required.

Skills

Client management

Formulary operations

Clinical operations

Pharmacy plan design

Pharma contracting

Health plan/PBM modeling

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 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.

Caring. Connecting. Growing together.

This role requires a clinical aptitude to support clients in the growing Formulary Management Services (FMS) business segment, including identification and quantification of opportunities to maximize pharmaceutical rebate revenues and evaluation of these opportunities via financial therapeutic class models using client-specific actual claims data.

Hours: Monday - Friday 8:00 AM - 5:00 PM

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

Primary Responsibilities

• Deliver value to clients through consultations and presentations that focus on formulary strategies to help clients achieve clinical and financial goals
• Apply clinical and business knowledge to execute financial models to identify formulary strategies yielding payor cost-savings, which will require you to:
  • Evaluate client formularies and UM criteria
  • Read and understand client contracts and pharma contracts
  • Access and use pricing databases, formulary databases, billing databases, claims databases
  • Run, develop, and analyze client utilization and spending reports
• Develop & present client-facing materials that are clear, concise, and effective; must be able to simplify complex subjects without compromising content
• Work cross-functionally to understand end-to-end operations, and manage deliverables, expectations and timelines with internal and external partners
• Contribute to team business objectives
• Use soft skills to build and foster relationships with internal and external partners
• Serve as a subject matter expert on assigned therapeutic class strategies
• Actively pursue continuous quality and process improvement in self and work tasks
• Up to 10% travel may be required

You will 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

• 2+ years of experience in three or more of the following:
• Client management or client-facing role
• Formulary operations, strategy, development
• Clinical operations (P&T, UMs, pipeline)
• Pharmacy plan design or new client implementation
• Pharma manufacturer discounts contracting, billing, or modeling
• Health plan/PBM financial modeling experience

Preferred Qualifications

• 5+ years of experience in a client-facing role
• 3+ years of clinical experience (e.g Pharmacist, Nurse, physician)
• Possesses excellent communication and interpersonal skills
• Ability to deal comfortably with ambiguity, uncertainty and risk, and can make high-quality decisions with less than perfect information
• Ability to change course quickly in a fast-paced environment
• Ability to demonstrate resourcefulness, and have the ability to innovate and problem-solve with initiative and ingenuity

Pay

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 $112,700 - $193,200 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.