Pharmacy Resident/ Fellow - Managed Care

Requisition Number: 2366387
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
This position is responsible for developing, implementing, monitoring and assisting in projects/programs that enhance the care of members in both commercial and Medicare advantage health plans. This position is also responsible for assisting the Pharmacy Health Plan Services area in the management of the Medicare Advantage Part D prescription benefits and after-hour prior authorizations as needed. Under the supervision of the Director of Pharmacy- Health Plan Services, this position is routinely responsible for audits and monitoring functions that help ensure prescription benefits are administered cost effectively, timely, accurately and in compliance with CMS standards.
Primary Responsibilities:

• 80% Develop, implement, and monitor projects/programs that enhance the care of members in all health plans as well as the financial abilities of the department
• 5% Assist with data collection interpretation and reporting
• 5% On Call for Prior Authorizations.
• 5% Other duties as assigned

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.
Required Qualifications:

• Graduate School of Pharmacy
• Intern state license; must obtain Texas
• Pharmacy License within 90 days of hire
• 1+ years of pharmacy experience
• Proven ability to communicate with other healthcare and company personnel to delegate duties, inform about policies, train, assist with program development and implementation
• Proven ability to communicate with members to handle complaints and problems, assist with questions, and recommend products.

Preferred Qualifications:

• HMO and 3rd party managed care experience
• Experience with presentations
• Proven ability to problem solve and to present suggestions and solutions in a clear and concise manner

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.