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Vice President, Formulary Operations - Government Programs - Telecommute

Company: UnitedHealth Group
Location: Eden Prairie
Posted on: September 15, 2022

Job Description:

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) -The Vice President, Formulary Operations - Government Programs will be accountable for the implementation, administration, and maintenance of formularies for OptumRx's Medicare and Individual Exchange clients. -This role will oversee all supported formulary activities, including but not limited to regulatory formulary filings, formulary build processes, formulary configuration and testing, and the production related formulary collaterals. -As a key leader within the Government Programs organization, the Vice President of Formulary Operations may represent the team within broader organizational initiatives and/or within client meetings. -This individual will work across the organization to build constructive partnerships with other business functions such as benefit operations, implementation management, account management and information technology. -This core leadership position will be a champion for operational excellence, using data driven approaches to measure performance and identifying opportunities for continuous process improvement. The Vice President, Formulary Operations will provide vision and guidance to a sizable team comprised of both clinicians and non-clinical staff, leading through example, and fostering a rewarding work environment.You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

  • Develop and maintain processes to validate the timely and accurate administration of end to end formulary operations for Medicare clients
  • Partner with Formulary Strategy leaders, Client Management and Regulatory partners to ensure formulary policies and procedures meet contractual and regulatory requirements
  • Coordinate with regulatory and compliance partners to stay current with new guidance and ensure all formulary designs comply with applicable requirements
  • Lead the implementation and testing of formulary functions prior to deployment
  • Lead the development and ongoing maintenance of policies and procedures which ensure formulary changes are implemented timely and accurately
  • Oversee the development, maintenance, and review of formulary materials where delegated to OptumRx
  • Coordinate with all formulary stakeholders, including Formulary Strategy leaders, Client Management and clients to lead responses to state and federal (CMS) inquiries for formulary related activity
  • Provide subject matter expertise within regulatory audits pertaining to formulary administration activity
  • Oversee efforts to research formulary related questions and system issues, providing direction to core subject matter experts to resolve open issues and document results
  • Represent Government Programs Formulary Operations within the participation of regular operations reviews that address ongoing performance, understand variance to targets and propose business process improvements
  • Oversee the presentation, explanation and/or interpretation of formulary operations data to internal and/or external customers (e.g., written reports; PowerPoint presentations; verbal communications)
  • Champion efforts to drive continuous process improvement within Government Programs Formulary Operations, working to improve operational quality, reduce unnecessary costs, and expand capabilities to support future growth
  • Develop and present business cases for future investment within the Formulary Operations area, inclusive of long-term impacts costs and applicable ROI models
  • Developing annual operational business plans to ensure alignment of priorities and associated operating models with evolving business and product strategy
  • Define Key Performance Indicators (KPIs) which are used to routinely evaluate operational performance
  • Foster positive working relationships with key business functions across the organization, including but not limited to: Benefit Operations, Marketing, Implementation, Regulatory and Account ManagementYou'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:
    • Registered pharmacist with license in good standing within a US State or Territory
    • 10+ years of Managed Care experience with Government Programs (Medicare and/or Medicaid)
    • 5+ years of Medicare formulary management experience
    • 5+ years of leadership experience, guiding teams within a professional environment
    • Experience leading clinical preparedness for regulatory audits, including audit participation
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationPreferred Qualifcations:
      • Effective influencing skills to successfully manage and lead in a matrixed environment
      • Demonstrated ability to build internal and external relationships with key stakeholders
      • Skilled communicator with ability to adapt written and verbal communication to needs of the audienceTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $134,200 to $257,700. The salary range for Connecticut / Nevada residents is $134,200 to $257,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Eden Prairie , Vice President, Formulary Operations - Government Programs - Telecommute, Executive , Eden Prairie, Minnesota

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