[Hiring] Clinical Program Analyst @UnitedHealth Group

Role Description

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.
• Cross-collaboration with a large matrixed environment, requiring developing rapport, relationships, and trust.
• Ensuring compliance with CMS guidance of programs and satisfaction of clients warranting movement of the needle in terms of Stars Rating Elevation.
• Managing time-sensitive issues required by CMS and other regulatory bodies, which may require extended work hours.

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%-25%) and program data analysis and Strategy Development (85%-75).
• 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.
  • 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.
  • 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.

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.

Requirements

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

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).
• Salary range from $91,700 - $163,700 annually based on full-time employment.

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.