Job Description

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UnitedHealthcare is seeking an experienced oncology pharmacist to serve as a clinical and strategic leader for oncology medications across the medical and pharmacy benefits. This role will shape clinically sound, operationally feasible, and affordable coverage strategies while protecting appropriate member access and supporting providers, customers, and enterprise partners.

The Senior Clinical Pharmacist will be a primary pharmacy subject matter expert for the oncology portfolio, including the Cancer Guidance Program, oncology clinical policies and pathways, Prescription Drug List (PDL) and preferred-product strategies, utilization management, site-of-care optimization, medical drug exclusions, biosimilars, dose optimization, and emerging therapies. The pharmacist will translate rapidly evolving oncology evidence into practical coverage, program, and affordability recommendations and will help move those recommendations through governance and implementation.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Oncology clinical strategy and evidence review
• Lead clinical pharmacy strategy for oncology drugs covered under both the medical and pharmacy benefits, balancing evidence, safety, member access, provider impact, operational feasibility, and affordability.
• Continuously evaluate FDA approvals, pivotal and real-world evidence, National Comprehensive Cancer Network (NCCN) recommendations, compendia, professional society guidance, comparative effectiveness, safety, sequencing, duration of therapy, and the oncology pipeline.
• Assess newly launched therapies and existing treatment classes to identify clinically supported management opportunities, including preferred products, biosimilars, therapeutic alternatives, exclusions, dose rounding or banding, duration management, and site-of-care strategies.
• Convert complex clinical findings into clear recommendations for clinical, operational, financial, executive, customer, and provider audiences.
• Clinical policy, pathways, and governance
• Own or provide senior clinical oversight for oncology medication policies, related pathway maintenance, and supporting clinical criteria.
• Develop, revise, and maintain prior authorization and medical-necessity criteria, policy language, coding considerations, and operational guidance for oncology therapies and supportive care medications.
• Prepare and present oncology recommendations to the Pharmacy & Therapeutics Committee, PDL Management Committee, and Oncology Advisory Committee governance forums.
• Coordinate pathway updates and related governance materials, documenting evidence, rationale, implementation impacts, and required stakeholder decisions.
• Program leadership and operational partnership
• Serve as a key UnitedHealthcare pharmacy partner for the Cancer Guidance Program, including policy interpretation, prior authorization workflows, escalations, implementation readiness, and program enhancements.
• Partner with oncology medical leadership and the oncology value creation team on Cancer Therapy Pathways and future oncology strategies.
• Provide clinical leadership for oncology site-of-care initiatives, including drug and setting suitability, medication sourcing, provider considerations, network implications, and exception criteria for clinically complex patients.
• Advance oncology affordability programs such as preferred-product strategies, biosimilar adoption, medical drug exclusions, dose optimization, and duration management while monitoring for unintended member or provider disruption.
• Analytics, trend, and affordability
• Use utilization, claims, market share, prescribing, reimbursement, and financial information to evaluate oncology trend drivers and quantify management opportunities.
• Partner with PDL strategy, contracting, analytics, specialty pharmacy, network, and medical cost teams to develop recommendations that balance savings, affordability, access, and provider feasibility.
• Monitor program performance and clinical outcomes; identify leakage, exceptions, operational barriers, and opportunities for iterative improvement.
• Provide oncology expertise for high-cost claimant reviews, executive summaries, trend discussions, customer questions, and emerging-therapy planning.
• Stakeholder engagement and communication
• Act as a trusted oncology pharmacy resource for UnitedHealthcare and Optum stakeholders, including pharmacy, oncology medical leadership, medical benefit management, network, specialty pharmacy, product, finance, marketing, customer teams, and account management.
• Participate in provider and health-system discussions regarding oncology policy, pathways, site of care, medication access, and program implementation.
• Develop or review customer-facing presentations, issue briefs, clinical summaries, FAQs, and educational materials for employers, brokers, consultants, providers, and internal teams.
• Build durable cross-functional relationships in a highly matrixed environment and drive work through influence, clinical credibility, disciplined follow-through, and clear communication.
• Mentor colleagues and share oncology expertise across the clinical pharmacy team. Depending on final organizational design, the role may include direct people leadership.
• Lead assigned Value Based Care delegation, capitation, clinical, claims, system, and operational-readiness implementations across Medicare Advantage, Commercial, Special Needs Plans, and/or Medicaid
• Develop and manage integrated project plans that define scope, deliverables, milestones, dependencies, target dates, accountable owners, and go-live requirements
• Facilitate mid- to large-size cross-functional workgroups, establish clear expectations, and drive disciplined completion of actions and decisions
• Coordinate implementation activities across functions such as provider setup, benefits, ID cards, claims, portals, member and provider services, enrollment, encounters, capitation, clinical operations, utilization management, and misdirected claims
• Identify, document, and manage project risks, issues, assumptions, and dependencies; remove barriers with urgency and escalate critical concerns with clear options and recommendations
• Drive delegate and internal readiness by confirming regulatory, system, process, operational, and business requirements are completed and validated in advance of go-live
• Partner with subject matter experts and stakeholders to clarify requirements, sequence work, resolve open items, and maintain alignment to project scope and strategic objectives
• Prepare accurate, timely status reporting that communicate progress, readiness, risks, decisions, and support needed from stakeholders or leadership
• Plan and coordinate effective handoffs to operational owners, including documentation, ownership confirmation, knowledge transfer, and stabilization support
• Use Smartsheet and other team tools for project planning, status management, reporting, workflow execution, and portfolio visibility
• Establish and maintain effective relationships with delegated entities, internal customers, functional subject matter experts, business partners, technology teams, operations, and leadership
• Apply project lifecycle experience and lessons learned to strengthen implementation standards, tools, governance, and delivery consistency
• Drive process-improvement activities by defining problems, gathering relevant information, facilitating stakeholder input, and implementing practical solutions
• Continue developing end-to-end knowledge of global risk, capitation, delegation, applicable regulations, supporting platforms, and the business teams involved in delivery

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 provide development for other roles you may be interested in.

Required Qualifications:

• Doctor of Pharmacy degree
• Active, unrestricted pharmacist license in at least one U.S. jurisdiction, with the ability to maintain licensure throughout employment
• Board Certified Oncology Pharmacist (BCOP)
• 2+ years of progressive oncology pharmacy experience in direct patient care, managed care, health plan, PBM, oncology pathways, medical benefit management, specialty pharmacy, pharmaceutical industry, or a closely related setting
• Experience presenting complex clinical recommendations to multidisciplinary committees or senior stakeholders
• Demonstrated solid written, verbal, analytical, project leadership, and relationship-management skills
• Demonstrated ability to critically evaluate oncology literature, guidelines, compendia, clinical pathways, treatment sequencing, supportive care, and emerging therapies

Preferred Qualifications:

• Postgraduate residency training, preferably PGY1 plus PGY2 oncology, or equivalent advanced oncology practice experience
• Experience within a national or regional health plan, PBM, medical benefit manager, oncology pathway organization, integrated delivery network, or large oncology practice
• Experience developing, interpreting, or operationalizing oncology coverage policies, prior authorization criteria, pathways, formularies, or utilization-management programs
• Experience with oncology site-of-care programs, biosimilars, dose rounding or banding, duration management, therapeutic or medical drug exclusions, and preferred-product strategies
• Experience using claims, utilization, market-share, and financial analyses to develop and monitor affordability initiatives
• Experience engaging providers, employers, brokers, consultants, manufacturers, or external clinical stakeholders
• Experience leading complex, cross-functional initiatives in a matrixed organization; formal people leadership or mentoring experience is a plus
• Working knowledge of medical and pharmacy benefit design, HCPCS/J-codes and NDCs, buy-and-bill, white-bagging or alternate sourcing models, specialty pharmacy, provider reimbursement, and oncology network considerations

Core Competencies:

• Oncology expertise and clinical judgment: Applies current evidence while recognizing patient heterogeneity, sequencing complexity, and operational realities
• Strategic and financial acumen: Connects clinical decisions to trend, affordability, provider economics, and business objectives without compromising clinical defensibility
• Execution discipline: Moves recommendations from concept through governance, implementation, communication, and performance monitoring
• Influence and collaboration: Builds alignment across medical, pharmacy, operations, network, finance, legal, and customer-facing teams
• Communication: Makes complex oncology topics understandable and actionable for clinical and non-clinical audiences
• Innovation and continuous improvement: Identifies scalable solutions, questions legacy processes, and anticipates the implications of a rapidly changing oncology market

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.