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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:




Approximate Salary:

Not Specified

Position Type:

Full Time

Manager, Clinical Pharmacy – Prior Authorizations

UHG - Las Vegas, Nevada

Posted: 11/15/2018

The Manager, Clinical Pharmacy – Prior Authorizations performs research, develops and maintains clinical pharmacy programs, such as drug utilization review, prior authorization, health outcomes, disease state management, care management, and other specialty programs. Participate in formulary development and maintenance. Research new prescription drugs or new applications of existing drugs and develops drug use guidelines. Prepare drug review information for presentation to Medical Director. Provide quality oversite to various programs to ensure regulatory compliance.  Position will consist of time working on corporate clinical initiatives, prior authorizations and with network providers. The position will be responsible for creating strategic clinical initiatives and managing a team of Prior Authorizations Pharmacists.
Primary Responsibilities:
  • Oversight of Plan Clinical Pharmacy Programs
  • Prior Authorization for Commercial and Medicaid members
  • Physician interaction
  • Evaluate patients medical records and make medication recommendations
  • Assist on various department projects and initiatives
  • Manage daily processes and personnel

Required Qualifications:
  • 3 + years as an active Pharmacist
  • Current and unrestricted Pharmacist license for the State of NV
  • Bachelor's Degree in Pharmacy
  • Strong drug product and clinical pharmacy knowledge
  • Intermediate level of experience with Microsoft Word and Outlook with the ability to navigate a Windows based environment
  • Excellent verbal and written communication skills
  • Excellent interpersonal and problem-solving skills
  • Strong customer service orientation and commitment to professionalism
  • 2+ years’ experience working in a clinical pharmacy practice setting
  • Experience developing or operationalizing medication clinical guidelines
  • 2+ years’ experience working with a PBM company and / or managed healthcare system
  • Prior Authorization experience
Preferred Qualifications:
  • PharmD degree
  • Staff management experience
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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
Job Keywords: Pharmacist, Pharmacy, PharmD, Las Vegas, NV, Nevada

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