Clinical Administrative Pharmacist

UnitedHealth Group - Tennessee3.6

30+ days agoFull-time
You're looking for something bigger for your career. How about inventing the future of health care? OptumRx is creating an innovative approach to Pharmacy Benefit Management. Here you'll find a professional culture where you can use your talent and our resources to make an impact on a huge scale. Take this opportunity to start doing your life's best work.(sm)

This particular position is for the TennCare (TN Medicaid) request for proposal (RFP). Employment is contingent upon contract award.

State of Tennessee
Department of Finance and Administration
Division of Health Care Finance and Administration
Bureau of TennCare
Request for Proposals for Pharmacy Benefit Management

The Clinical Administrative Pharmacist will be dedicated to the Health Care Finance and Administration’s (HCFA) Medicaid Programs, TennCare, CoverRx and CoverKids.

Primary Responsibilities:
The Clinical Administrative Pharmacist shall be licensed by the State of Tennessee Board of
Pharmacy and whose duties shall include, but are not limited to:
TennCare Prior Authorization (PA) program and process
TennCare First Level PA Appeals process
TennCare Pharmacy Lock-In process
Assistance with the TennCare Pharmacy Audit process

Required Qualifications:
BS degree in Pharmacy or PharmD
Current and unrestricted Pharmacist license in the state of Tennessee
Minimum 1 year of experience working as a licensed Pharmacist
Proficiency in Microsoft Word, Excel and Outlook

Preferred Qualifications:
Medicaid Fee For Service or Medicaid Managed Care experience
PBM experience
Prior Authorization experience
Pharmacy Audit experience
Client facing or clinical account management experience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)