
ptum 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 a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position supports the Medicaid line of business by ensuring continuity, accuracy, and timeliness of drug file management, formulary updates, and related reporting activities. The role focuses on weekly drug file reviews, coverage decisioning, attending quarterly Pharmacy & Therapeutics (P&T) meetings and aid in the preparation of the P&T meetings material. The position serves as backup support to the Account Manager and clinical pharmacist in maintaining compliance with contractual and regulatory requirements.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
Required Qualifications
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.
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 marginalized 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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
This position supports the Medicaid line of business by ensuring continuity, accuracy, and timeliness of drug file management, formulary updates, and related reporting activities. The role focuses on weekly drug file reviews, coverage decisioning, attending quarterly Pharmacy & Therapeutics (P&T) meetings and aid in the preparation of the P&T meetings material. The position serves as backup support to the Account Manager and clinical pharmacist in maintaining compliance with contractual and regulatory requirements.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
- Review weekly drug compendia drug file to assess coverage status of newly released medications
- Analyze clinical data, comparative drug reports, cost metrics, and utilization trends to develop evidence-based drug criteria
- Recommend drug placement strategies for client formulary based on clinical and financial evaluations
- Prepare and deliver error-free quarterly drug formulary change requests for approved changes from P&T meetings
- Review and perform quality checks of all pre- and post-P&T deliverable documents along with virtually attending quarterly P&T meetings
- Support all weekly, monthly, quarterly, and annual formulary-related and contractual deliverable reports
- Present findings and updates to clients confidently; serve as a backup for the account manager and clinical pharmacist when needed
Required Qualifications
- Active PharmD license
- 2+ years of experience in formulary management and clinical data analysis
- Experience in communicating to clients and presenting data
- Experience working collaboratively in cross-functional teams and client-facing environments
- Intermediate proficiency with drug databases and reporting tools (e.g., MediSpan, Excel)
- Experience with fee-for-service Medicaid plans
- Working knowledge of CMS rules, regulations, and guidance regarding Medicaid
- All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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.
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 marginalized 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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
About the company
Company website•Hospitals and Health Care
We’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. We are delivering the right care how and when it’s needed; providing support to make smarter and healthier choices; and making prescription services easier, while helping you save money along the way. It’s everything health care should be. Together, for better health.
Optum is part of UnitedHealth Group (NYSE: UNH).

