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Associate Director- Formulary Management Strategy
1 month ago
Optum is a global organisation 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 a culture guided by diversity and inclusion, 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.
About the Role:
In healthcare, evolution doesn’t just happen. It takes innovation, imagination, and a passion for solving problems in new and better ways. And innovation is taking place at a lightning-fast pace every day at Optum.
As the fastest growing part of the UnitedHealth Group family of businesses, we’re expanding our team in Ireland and creating excellent opportunities for those who want greater purpose and more impact in their work. We’ll provide the investment, support, and resources to advance your career. You’ll provide the talent, ambition, and drive.
As the Associate Director of Formulary Management Strategy you will drive development of United HealthCare formularies or Prescription Drug Lists (PDLs). You will lead coverage and utilization management decisions for pharmacy and medical benefit drugs based on financial modelling and strategic analysis. To achieve these goals, you will build relationships with cross-functional stakeholders including Clinical, Finance, Legal, and OptumRx Industry Relations teams.
Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny office and telecommuting from a home-based office in a hybrid work model.
Primary Responsibilities:
• Drive development of the PDLs and accompanying utilization management programs for the Commercial business to achieve affordability and savings targets, manage trend and improve quality for approximately 14M covered lives.
• Drive development of coverage strategies for medications covered under the medical benefit to achieve affordability and savings targets, manage trend and improve quality for approximately 22M covered lives.
• Work in conjunction with PBM to develop formulary management strategies, as appropriate, and obtain industry-leading pricing for drugs covered under both the pharmacy and medical benefit.
• Collaborate with team providing analytics, e.g. mine claims data to understand current utilization patterns, develop and modify models to estimate financial impact of various coverage strategies, track and evaluate outcomes of PDL placement, utilization management and other programs.
• Represent PDL strategies to internal and external stakeholders (including key senior leaders) to gain support, including providing evidence of underlying need or opportunity, rationale for decisions and expected impact of any changes.
• Monitor US healthcare market with respect to assigned therapeutic areas and serve as subject matter expert on upcoming market events, trends, risks, and opportunities.
• Demonstrate clinical understanding of drug / therapeutic categories for assigned classes, including clinical drug guidelines and UHC Pharmacy & Therapeutics Committee clinical designations.
You will be rewarded and recognised 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 providing development for other roles you may be interested in.
Required Qualifications:
• Bachelor’s degree
• Experience leading initiatives that contribute to measurable financial impact, especially cross-functional efforts involving multiple business units
• Excellent verbal and written communication skills; ability to speak clearly and concisely, ability to understand, interpret, and convey complex technical information in an audience-specific manner
• Strong interpersonal skills, history of establishing rapport and working well with both internal and external colleagues
• Proven ability to work collaboratively with multiple teams or departments to problem-solve and support achievement of business goals
• Intermediate MS Office Excel skills (e.g. V-lookups and Pivot tables)
Preferred Qualifications:
• Advanced degree (MBA, PharmD, MS) and/or bachelor’s degree in pharmacy
• Experience in strategy development and proficiency in performing financial impact analysis using financial, forecasting and other data analysis tools
• Experience working in managed health care, pharmacy benefit management, and/or pharmaceutical industry
• Experience with data visualization tools such as Tableau or Power BI
Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.
All telecommuters will be required to adhere to the UnitedHealth Group’s 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 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 marginalised 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.
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2024 Optum Services (Ireland) Limited. All rights reserved.
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