[Hiring] Clinical Program Consultant @UnitedHealth Group

Role Description

As the Clinical Program Consultant, Affordability Medical Drug Benefit, you will identify and execute affordability opportunities, and execute strategies to address them, including contracting and affordability program development across the commercial book of business. Your overarching focus will be on identifying areas of affordability for drugs managed on our medical benefits. This role will engage with network leadership to define contracting/reimbursement standards and strategies, along with process controls, and support their successful implementation, to produce predictable unit cost and trend across our enterprise. This position will also support clinical UM program implementation and help drive cross-functional collaboration between Network and Pharmacy, because we recognize we are ‘Better Together’. You’ll partner with leadership across our enterprise, including data and analytics, legal and regulatory, clinical, HCE, network management and pharmacy experts.

This position requires a motivated self-starter who has the flexibility and versatility to pivot to adjust to evolving business needs and to lead a team of individuals in the same manner. This individual will engage with enterprise leadership, presenting and gaining support for affordability strategies. This individual will focus relentlessly on execution and value delivery, balancing speed and quality. The Associate Director reports to the Director of Medical Benefits, Clinical Strategy within UHC E&I.

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

Primary Responsibilities

• Create and drive incremental affordability based on analysis of performance results, opportunity identification, and enterprise business strategies.
• Lead development of affordability program strategies including business requirements, process flows and implementation, in conjunction with legal/regulatory, clinical, operations, technology and other key partners.
• Collaborate with other network/affordability leaders to ensure programs and priorities align across the broader enterprise, avoiding redundancy.
• Own contracting affordability program execution from UHC Pharmacy perspective, managing scope, timelines, and stakeholder expectations, to drive an integrated value proposition for pharmacy trend and spend.
• Translate affordability strategy into tactics the organization can execute against with key milestones, responsibilities, and defined dates.
• Work collaboratively with cross-functional teams including clinical and strategy leaders within UHN, clinical team, operations, program management, technology, legal, Optum MBM, and other internal teams to execute roadmap.
• Establish, analyze and report key metrics to ensure optimal business results and ongoing performance.
• Be able to communicate and educate network on relevant network, pharmacy, and regulatory trends, along with competitor offerings.
• Manage competing priorities and work in a fast-paced environment.
• Learn, navigate and communicate end to end processes.

Qualifications

• 5+ years of experience in pharmacy and/or facility/provider contracting roles, with a focus on affordability management and development/implementation of drug payment strategies.
• 5+ years of health care industry experience.
• 3+ years of experience in strategy implementation and program operations/development process.
• Demonstrated experience presenting strategic and performance level information to large audiences.
• Demonstrated expertise influencing to drive decision-making.
• Demonstrated expertise analyzing business data and trends to identify new opportunities for business growth and improvement in provider/member experience.

Preferred Qualifications

• Experience network and/or product/operations teams.
• Excellent verbal and written communication skills including MS Word, Excel, and PowerPoint skills.
• High attention to detail including ability to manage multiple, competing priorities simultaneously.
• Willingness to roll up your sleeves and do whatever is necessary, owner mentality.
• Demonstrated ability to think strategically and execute methodically.
• Demonstrated solid interpersonal, communication and Excel skills.
• Demonstrated solid analytical, project management and critical thinking skills.
• Demonstrated ability to think creatively and comfort being hands-on in a fast-paced environment.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

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.

Company Description

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. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

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.