Account Consultant Pharmacist - Remote in WA State

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Providing outstanding service to our Medicaid Health plans takes a solid mix of business skills, technical proficiency, and industry knowledge. We have a strong team of pharmacists and pharmacy service specialists, and we are looking for a talented individual to join us as we grow our business. In this position, our new team member will have the opportunity to develop expertise in the Medicaid and DSNP business.

The Plan Pharmacy Director serves as the primary point of contact and is accountable to the United Healthcare Community Plan of Washington Plan leadership and the state Medicaid agency related to execution of the pharmacy benefit program and strategy.

Position is Plan Pharmacy Director, a dedicated resource and key staff of the United Healthcare Community Plan of Washington health plan; that is accountable for setting the strategic direction, operational execution, oversight and financial impact analysis of pharmacy program priorities for the health plan. The role includes preferred drug list (PDL) implementation and maintenance activities, pharmacy reporting, management of state pharmacy relationship, active engagement at pharmacy related meetings with internal and external stakeholders as the pharmacy subject matter expert, key contact for pharmacy to internal and external stakeholders, developing and executing pharmacy strategy, ensuring pharmacy benefit compliance, communicating pharmacy trends and value proposition, developing and executing on affordability initiatives, supporting clinical and quality initiatives.

This position will be part of the United Healthcare Community and State Pharmacy team, reporting directly into the Regional Director Pharmacy Services.

If you are located in the State of Washington, you will have the flexibility to work remotely
* as you take on some tough challenges.

• Executes the pharmacy benefit and compliance with the state contract, state policies, and state/federal statutes and regulations governing pharmacy
• Utilizes broad understanding of managed care and PBM knowledge to develop, execute, and drive strategic plans and goals
• Analyzes forecasting and trend information for operational and business planning
• Provides strategic direction, operational oversight, and financial impact analysis as it pertains to pharmacy program priorities for the health plan
• Builds and maintain strong relationships with internal and external partners and serve as the primary point of contact for Pharmacy and Pharmacy Services
• Assists plan on all pharmacy related activities including clinical program development and improving member satisfaction
• Accountable for creation and maintenance of state specific polices
• Serves as the SME SPOC for formulary, prior authorization and benefit coding requirements and execution and responsible for communication with stakeholders for implementation
• Demonstrates a strong working knowledge of health plan operations (compliance, finance, encounters, claims adjudications, networks, clinical, case management, HEDIS measures, etc.)
• Collaborates with internal partners to complete projects and to address on-going pharmacy service…