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Clinical Pharmacist
UnitedHealth Group
Source: Headcount Labs · original listing ↗
Job data: Headcount Labs, ODbL 1.0. Job descriptions belong to their employers.
Posted yesterday
About this role
Optum 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Pharmacist provides clinical expertise across Utilization Management, formulary management, and contracting activities within the OptumRx Ireland team. Responsibilities include clinical research and evaluation, development and maintenance of utilization management criteria, and supporting formulary placement strategies across more than 60 therapeutic classes. The role works cross-functionally with Clinical, Finance, Legal, Contracting, Operations, and Client Management to promote safe, effective, clinically appropriate, and cost-effective medication use. Working Schedule: This is a full-time position with working hours of 5 days a week. Standard working hours are typically 10:00am to 6:00pm. As this role operates within a US-based organization, some flexibility is required to accommodate later meetings or calls when business needs arise. *Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin and telecommuting from a home-based office in a hybrid work model.* Primary Responsibilities: * Apply clinical knowledge of therapeutics and evidence-based medicine to research and evaluate emerging therapies, new drug releases, medical literature, treatment guidelines, and healthcare trends, supporting the development of clinically appropriate drug coverage and formulary strategies * Develop and maintain clinical pharmacy programs and drug coverage policies, including formularies, prior authorization, step therapy, quantity limits, drug utilization review, health outcomes, disease state management, care management, and specialty pharmacy programs * Present clinical recommendations and utilization management criteria to governance committees, including the National Pharmacy & Therapeutics (P&T) Committee and Utilization Management Committee, providing clear clinical rationale and supporting evidence * Evaluate custom drug coverage requests and translate client requirements into clinically appropriate policy recommendations, working collaboratively with payer and client teams and considering pharmacy and medical benefit structures * Serve as a clinical subject matter expert across cross-functional initiatives, partnering with teams such as Operations, Account Management, Industry Relations, Finance, Legal, Contracting, and other Clinical teams to support formulary, utilization management, and broader pharmacy strategies * Support the implementation and ongoing management of pharmacy programs, contributing to business process design, system configuration and testing, troubleshooting, program updates, and operational readiness * Maintain an understanding of relevant U.S. healthcare and regulatory requirements, including Medicare Part D, and assess the impact of regulatory or legislative changes on existing and future clinical pharmacy programs. Review programs for applicable regulatory compliance and recommend remediation where required * Uphold high standards of clinical integrity and ethical practice, ensuring clinical recommendations and drug coverage policies support safe, effective, consistent, and equitable access to appropriate medications * Effectively manage multiple priorities and deadlines while working both independently and collaboratively within a dynamic, remote-first and cross-functional environment Required Qualifications: * PharmD or BS in Pharmacy * Current pharmacist license in good standing * Managed Care, PBM, health plan, or utilization management experience * Experience supporting clinical policy development, utilization management programs, or formulary management * Demonstrated ability to analyze complex clinical and operational issues and develop practical solutions * Solid written and verbal communication skills with proficiency in Microsoft Office applications * Experience collaborating across clinical, operational, technical, and business teams Preferred Qualifications: * Experience supporting claim adjudication logic, benefit coding, or utilization management system implementation * Experience gathering, documenting, and submitting business requirements for technology or operational initiatives * Knowledge of prior authorization, step therapy, quantity limit, specialty pharmacy, and formulary management programs * Experience participating in large-scale cross-functional projects involving product, technology, analytics, or operations teams * Completion of an accredited pharmacy residency or other advanced clinical training * Experience supporting AI, automation, or digital transformation initiatives within healthcare or pharmacy benefit management environments Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application. *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.* *Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.* *Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2026 Optum Services (Ireland) Limited. All rights reserved.*