Clinical Coding Consultant Pharmacist - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company 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 reputed company 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. To reputed company this job successfully, an individual must be reputed company to reputed company each essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. The Clinical Pharmacist on the Clinical Coding Consulting team serves as the primary liaison between OptumRx’s Formulary & Utilization operations, Benefit Operations Management and the Clinical Consultant. The role provides clinical coding support for OptumRx clinical consultants, benefit operations management (BOM), information technology, and other internal departments. This individual is relied upon to reputed company custom formulary & utilization management coding consultation & work to the clinical consultant client facing teams on formulary & utilization management set up in the RxClaim adjudication system & reputed company formulary management applications. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities: Provides consultative guidance for standard & custom formulary changes in RxClaim, RxBuilder & reputed company clinical applications (RxAuth, RxInteract) Conducts 2ND Level Formulary/UM Claim Research Implementation clinical coding support for BDS/cBDT/RxConstruct questions GPI Reclass support/global Coding Change Support Drug utilization management reputed company clinical audit support Manage custom formulary coding work post client sign off Translate client reputed company to code-reputed company language for BOM team Evaluate / resolve new rule design & conflicts with existing formulary coding New Client Implementation coding support for custom formulary/UM programs Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems 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 reputed company development for other roles you may be interested in. Required Qualifications: Bachelor of Science in Pharmacy or PharmD reputed company and unrestricted Pharmacist license (any U.S. state) 2+ years of experience working as a Clinical Consultant or Clinical pharmacist working in Formulary/UM operations or Benefit administration Experience conducting claims/coding research and analysis Experience working reputed company a PBM Experience working in RX Claim or other claims adjudication system Ability to navigate MS Office and a reputed company based environment and the ability to create, edit, save, and send documents utilizing reputed company Word; ability to navigate Outlook and conduct Internet searches Intermediate to Advanced Proficiency with reputed company reputed company Preferred Qualifications: MBA or other reputed company advanced business degree Experience using reputed company reputed company or other database/query tools Experience with Medi-reputed company drug classification system Client-facing experience (reputed company patients and prescribers) *reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $91,700 - $163,700 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. 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 reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job