As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm)
Under the direction of the VP, Clinical and Formulary Services, the Senior Director, Formulary Strategy serves as a dedicated formulary strategy leader responsible for identifying competitive OptumRx Commercial/Exchange/Medicaid formulary and trend management strategies to manage pharmacy spend. This position is will be responsible for designing and deploying proactive, comprehensive cost-management strategies to protect clients from undo financial exposure related to high-cost medications. This position will also provide sales support activity related to formulary and trend management, particularly with mid- to large-scale sized new business opportunities across market segments. Leadership activities in support of this role include, but are not limited to Proposal Development & Review, Prospective Clinical Data Review & Assessment, Presentation Preparation and Delivery.
Monitoring the competitive marketplace to serve as subject matter expert on our OptumRx Formulary offerings and how they compare and perform versus major competitors
Lead the innovative pipeline progression, define product enhancements and determine market positioning / messaging for commercial formulary and trend management strategies that lead to lower prescription costs for our clients
Set the strategic direction and provide guidance to the Formulary Strategy team from conceptualization through rollout, measurement and refinement across both formulary and utilization management programs
Oversight of the OptumRx commercial formulary change process including timely and accurate internal training as well as client and member notification
Provide strategic direction for the OptumRx Exchange formulary to be compliant with ACA legislation and competitive on the health insurance marketplace
Work closely with Sales, Marketing, Industry Relations, Clinical Consulting, Client Management and Pricing teams to define formulary and trend management parameters, develop strategies to address client issues and achieve maximum impact on sales and contract renewals
Work with Clinical Analytics and others to develop clear and effective prospective analytics, outcomes reporting, value proposition and product story to demonstrate value to prospective clients
Serve as liaison between the Clinical Services team and other cross-functional areas, including Industry Relations, Formulary Operations, Clinical Analytics, and Sales (Clinical Consultants; Account Management; Sales Team) to gain clear and up-to-date understanding of changing marketplace needs relative to formulary-related strategies
Spearhead training efforts to educate all key stakeholder areas regarding new formulary / trend management activities and routine refinements to existing offerings
Ensure that enhancement and new initiatives are clinically sound, financially appropriate for both the Company and its customers, and meet or exceed customer goals
Oversee the management of the entire life cycle from strategic planning to tactical activities through hand off to the operations team
Ensure that Formulary Strategy is aligned with Company financial, client retention and innovation goals, as well as with emerging technologies, market trends, market forecasts, and customer goals
Quickly adapt to market changes
- BS Pharmacy
- Active, unrestricted pharmacist license
- 8+ years of managed care pharmacy experience
- 5+ years of leadership experience, strong motivator of team and cross-functional teams
- 3+ years regular interface with senior leadership levels on projects / initiatives
- 5+ years of extensive involvement in managed healthcare clinical pharmacy strategy
- 3+ years hands-on experience in formulary management
- Proficiency in Microsoft Word, Excel, PowerPoint, Outlook
- Doctor of Pharmacy degree
- Pharmacy residency
- Demonstrated clinical and analytic skills and background
- Ability to conceptualize, align and explain strategic vision based upon multiple complex parameters, including healthcare marketplace, market trends, competitor products, emerging technologies, business opportunities, company goals, client and consultant requests, product value, product development capabilities and product development process
- Sound understanding of formularies across different lines of business (e.g., commercial, Medicaid, exchanges) and marketplace needs
- Ability to think externally and strategically
- Demonstrated experience working with all levels of cross-functional teams (executives, managers, analysts)
- Ability to build out comprehensive and effective business plans that support future formulary / trend management strategies requiring capital investment for support
- Excellent communication, presentation and interpersonal skills
- Ability to make judgments about the value of ideas, needs and resources, and to effectively communicate the advantages and disadvantages of each to other decision makers
- In-depth knowledge of the healthcare industry from both clinical and business perspectives
- Ability to manage multiple projects simultaneously
- Creative, high-energy self-starter with broad background, creative drive, and innovative solutions to business needs
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
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.