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Pharmacy Manager, Clinical Quality Performance - Remote

Optum
401(k)
Jan 31, 2025

Optum New York, (formerly Optum Tri-State NY) is seeking a Manager of Clinical Quality Performance, Population Health to join our team in Lake Success, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Position Highlights & Primary Responsibilities:



  • Support VP of Quality and Provider Enablement leveraging local market knowledge, establishing, and driving local tactical plans for improving CMS Star ratings and quality for Optum East RBE
  • Support VP of Quality and Provider Enablement as they coordinate with National Quality, Optum East Quality Team and Market Operations monitoring historical and current data trends to support strategic planning and development
  • Supports VP of Quality and Provider Enablement to address medication adherence issues, statin use in diabetics gap, statin use in persons with cardiovascular disease gap and other medication related STAR/HEDIS gaps for Medicare populations
  • Develop innovative strategies to support adherence and disease state management improvement goals across Optum East Region RBE
  • Leverages data analytics and tools to identify trends and opportunities to performance improve outcomes for Patients and Members new to therapy and with social risk factors
  • Work with regional leadership to set quality performance goals and develop operating plans for improving performance against contracted payer measures
  • Carry out special projects as assigned; designs, develops, and maintains analyses and reports, including graphic presentation and dissemination
  • Maintain strong relationships with Optum East RBE cross regional partners and health plan leaders through regular communications and face to face contacts
  • Motivate and inspire other team members
  • Exemplify and model Our United Culture and live our values with conviction



The Optum Health East region is seeking an experienced pharmacist to provide leadership and support to drive STAR's quality improvement and overall program management support. You will work within highly matrixed relationships supporting the VP of Quality and Provider Enablement. In this role, you will coordinate across multiple functional areas including but not limited to: Analytics, Clinical, Pharmacy, Physician Engagement, Market Operations, Member Experience, Benefit Design/Product, and Behavioral Services as needed to support quality outcomes and STARs improvement activities.

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:



  • BS Pharm or Pharm D degree from an accredited college or university
  • Current, unrestricted Pharmacist license in any state
  • 5+ years of Clinical Pharmacist experience
  • 3+ years of STAR's/HEDIS experience
  • Proficiency in Microsoft software applications that include but are not limited to Microsoft Word, Excel



Preferred Qualifications:



  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
  • Ability to work independently within a cross functional team environment with frequent interruptions and shifting priorities
  • Ability to effectively communicate analysis verbally and in writing to clients and business partners
  • Experience working directly with providers and/or patients in retail pharmacy, ambulatory care clinic, hospital or similar facilities



*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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