Pbm Implementation Jobs in Tennessee (NOW HIRING)

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 to start Caring. Connecting. Growing together.

If you are based/reside in state of TN, you will have the flexibility to work remotely as you take on some tough challenges.

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, prior 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.

• 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 equivalent residency experience
• Formal presentations experience
• Experience working in a client facing or clinical account management role
• Proficiency in Microsoft Word, Excel, PowerPoint and Outlook
• Currently reside in the state of Tennessee
• Ability to travel up to 10% of the time

• FeeForService Medicaid and/or Medicaid Managed Care experience
• PBM experience
• Experience with or knowledge of Pharmacy Advisory Committees, DURB (Drug Utilization Review Board) and/or P&T Committees
• PBM Implementation experience
• Experience in medical writing
• Clinical analytical skills

*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.

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.