1+ months

Associate Director of Clinical Pharmacy - RI, MA, and CT

Providence, RI 02903
  • Job Code
    850217

The Associate Director of Clinical Pharmacy is responsible for engaging our network providers and local pharmacies in discussions related to Part D quality measures and programs primarily for our Medicare and Retirement business. Performance management is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and improved quality. The person in this role is expected to work directly with our clinical quality team, providers and pharmacies to build relationships, ensure effective education and share reporting specifically focused on Part D measures. They will proactively identify performance improvement opportunities through data analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results.

 

If you are located in the state of Rhode Island, Massachusetts, or Connecticut, you will have the flexibility to telecommute* as you take on some tough challenges.

 

Primary Responsibilities:

  • Functioning independently, travel across assigned territory to meet with providers to discuss Optum and UHC tools and programs focused on improving the quality of care for Medicare Advantage Members specifically focusing on medication adherence and high risk medications
  • Strategize with our Optum and United HealthCare quality team in the development of training and analytical materials for Stars and HEDIS, with a primary focus of medication adherence
  • Engage and collaborate with pharmacies; including the independent pharmacies across the state, to improve medication adherence of Medicare Advantage Members
  • Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
  • Develop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes
  • Provide ongoing strategic recommendations, training and coaching to provider groups and pharmacies on program implementation and barrier resolution
  • Act as lead to pull necessary internal resources together in order to provide appropriate, effective provider education, coaching and consultation; training will include Stars measures (HEDIS/CAHPS/HOS/med adherence), Optum program administration, and use of plan tools, reports and systems
  • Provide reporting to health plan leadership on progress of overall performance of pharmacy measures, gap closure, and use of virtual administrative resource
  • Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation
  • Provide suggestions and feedback to Optum and health plan
  • Provide clinical knowledge to our providers of chronic disease states in particular diabetes, hypertension and hyperlipidemia and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
  • Deliver high quality evidence-based therapeutic recommendations to providers
  • Work collaboratively with health plan market leads to make providers aware of Plan-sponsored initiatives designed to assist and empower members in closing gaps
  • Role includes up to 75% local travel

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.

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Posted: 2019-10-09 Expires: 2019-12-12

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Associate Director of Clinical Pharmacy - RI, MA, and CT

UnitedHealth Group
Providence, RI 02903

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