Associate Director, FFS Medicaid Clinical Consulting - Columbia, SC
UnitedHealth Group
- Location
- Columbia, South Carolina
- Work model
- On-Site
- Level
- Senior
- Salary
- $112.7k – $193.2k/yr
About this role
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. Here, you will find talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This Associate Director of Clinical Consulting will oversee clinical consulting client relationships, proactively identify clinical solutions, and manage clinical resource allocation for one or more of OptumRx's segments of Clinical Consulting support. They will work with clinical leadership in developing a strategy related to the delivery of proactive consultative services and driving clinical upsell targets, including deployment of appropriate use guidelines and protocols, utilization management strategies, clinical products / services, and formulary management strategies. The Associated Director of Clinical Consulting is expected to maintain strategic relationships with client leaders, key stakeholders, and brokers/consultants. The Associate Director of Clinical Consulting is accountable for direct management of a staff of clinical consultants and maintaining client satisfaction and retention. *Position is expected to start in January 2027 If you are located in Columbia, SC, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
Determine and manage clinical consulting resource allocation and assignment Provide routine reporting to clinical leadership regarding milestone attainment and any significant issues within their segment that may be impacting overall team performance Maintains understanding of individual client contracts and ensures proper execution of all clinical deliverables specific to those agreements Ensures alignment of PBM clinical priorities with strategic goals and objectives of the overall organization and client Collaborates with clients to establish achievable but aggressive clinical program goals, including generic dispensing rate improvements, implementation of utilization management programs, improvement in medication adherence rates, improvements in therapy gaps for key chronic disease states, formulary compliance targets, and HEDIS & NCQA measures Formulates and delivers clinically-sound and fiscally responsible recommendations to clients based on trend Provides mentoring / coaching for Clinical Consultants to enhance employee engagement, promote professional development and maintain high levels of staff satisfaction Assist in the recruitment, on-boarding and mentoring of new Clinical Consultant team members Provide superior clinical consultation and clinical account management with a focus on client satisfaction, client retention, and trend management Comprehends and effectively explains formulary and clinical program changes to clients Stays aware of and provides clinical market intelligence to clients Provides education for clients, pharmacists, members and physicians per contractual requirements Communicates drug information to clients and responds to plan-specific clinical inquiries in a timely manner Supports other revenue-enhancement efforts (e.g., specialty, formulary, UM, mail, etc…) in coordination with client mgmt./sales teams where appropriate Routinely collaborates with client management leadership peers to provide well-coordinated, impactful quarterly performance review sessions with clients Serves a key resource for new clinical product/service ideation and liaison to clinical product development / management areas to create new or enhance existing programs Identifies and collaborates with account management on clinical renewal strategies Drives enhanced client relationships through