Bilingual Pharmacist Clinical Consultant -Field - South Florida

Company: UnitedHealth Group
Location: Atlanta
Posted on: November 20, 2023

Job Description:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start -Caring. Connecting. Growing together. - -You'll enjoy the flexibility of a hybrid role, if you live within -the central or south Florida, -as you take on some tough challenges. -Must be willing to travel -50% -of your time within the main markets of Tampa, Orlando and South Florida. - - -Primary Responsibilities: -

• Develops and implements programs focused on Pharmacy (Part D) Stars Improvement, medication adherence and closing gaps in care toward improving care of health plan members and Star ratings
• Collaborates with participating providers in South Florida's STARS Pay-for-Performance (P4P) incentive program to establish achievable but aggressive clinical program goals, including generic dispensing rate improvements, implementation of utilization management programs, improvement in medication adherence rates, formulary compliance targets, and HEDIS and NCQA measures
• Manages 78% of PCN/PCP membership under risk agreements; 58% of membership under UHC Risk agreements
• Conducts special projects to maximize market goals - i.e., analyze Part B pharmacy utilization to reduce cost, partnering up with Sales and Network Management to educate Specialists on C-SNP pharmacy benefits
• Leads education efforts to Primary Care Physicians and Specialists on Pharmacy Star Initiatives and Stars performance programs
• Participates in monthly STARS JOC meetings with FL market leadership to discuss contract and measure level Part D performance
• Participates in Quarterly SFL Risk Provider JOC meetings to review performance, provide proactive clinical recommendations, review initiatives and pharmacy benefits
• Leads Monthly Part D meeting to discuss SUPD, SPC and Med Adherence best practices, challenges and/or barriers with segmented FL leaders.
• Handles provider general pharmacy-related inquiries as well as patient-specific matters
• Clearly communicates analytical and reporting needs to providers and internal departments such as Stars Network, Network Management, and Risk Performance
• Works with Part D Product team on formulary updates for annual benefit planning
• Contributes with Corporate Communications team to create and add the annual formulary changes document, diabetes reference guides and formulary guides to UHC provider site
• Develops initiatives to further improve overall star ratings and assists with special projects as needed to help the FL market achieve their goalsYou'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:
  • Undergraduate degree or equivalent experience
  • Pharm D degree from an accredited college or university
  • Current, unrestricted Pharmacist license in the state of Florida
  • 2+ years of Medicare Advantage Pharmacy Stars experience
  • 2+ years of clinical experience
  • Bilingual skills; Fluent in Spanish/English
  • Reliable Transportation to travel 50% of the time within the state of FL -Preferred Qualifications:
    • Clinical account management experience
    • Experience working with Medicaid/Medicare
    • Experience working with complex Health Plan clients w/complex benefit structures*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy - -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. - -

Keywords: UnitedHealth Group, Atlanta , Bilingual Pharmacist Clinical Consultant -Field - South Florida, Other , Atlanta, Georgia