Now Hiring - Optum, Inc. - Pharmacy Account Manager in South Burlington, VT

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your lifes best work.SM

The Account Manager is fully responsible for contract oversight from operations through the life of the contract. The Account Manager is fully accountable for all activities, work products, and deliverables performed by or produced by the Contractor, as set forth in the RFP.

If you reside in Vermont, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Serve as individual ultimately responsible for all contractor functions and requirements under this RFP and contract
• Interact communicate and coordinate to ensure continuity of contractor activities and responsibilities
• Act as primary point of contact with the state
• Responsible for all contractor requirements under this RFP and contract, and oversee contractor business processes and documentation
• Accountable for obtaining staff to perform subject matter expert parentheses (SME) responsible for all contract requirements
• Interact, communicate, and coordinate to ensure continuity of current pharmacy operational activities and responsibilities
• Lead staff on development, coordination, and publication of communication with outside entities, E.G., written provider communications, pharmacy related web content, ETC.
• Coordinate and communicate with providers associations and other outside entities, including the general public
• Initiate and manage system change requirements and documentation
• Accountable for all prime and or subcontractor resources who will perform work related to this RFP and subsequent contract
• Accountable for configuration of PDL elements, step therapy requirements, automated prior authorization criteria and all other PDL management criteria
• Acquire, analyze, maintain and inform ODM of recommended programs updates to comply with pharmacy benefit management best practices
• Responsible for staying well informed of any and all CMS, FDA, NCPDP, HIPAA or any governing bodies legislation, rule, guidance and or any other changes that may impact the Ohio Medicaid pharmacy program and sharing such information with ODM
• Responsible for reviewing and approving all deliverables that are required of the contractor

Required Qualifications:

• High School Diploma/GED (or higher)
• 5+ years of public sector pharmacy benefit management or pharmacy program oversight related experience
• 3+ years of project / contract management experience
• Intermediate level of proficiency with Microsoft Office products
• Currently reside within 30 miles of South Burlington, VT or willing to relocate to the area at your own expense
• Ability to travel up to 25% of the time

Preferred Qualifications:

• Demonstrated knowledge of state Medicaid policy and administrative rule
• Demonstrated knowledge of CMS rules, regulations and guidance regarding Medicare and Medicaid
• Demonstrated knowledge of pricing methodologies
• Extensive knowledge of an expertise with Medicaid claims processing and public sector pharmacy benefit management

• All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location, and incomedeserves 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.

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