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 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.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Establishes and maintains strong business relationships, and leads complex negotiations with Chain, Grocer, PSAO or Specialty pharmacies in support of clients
- Demonstrate understanding of complex contract language in order to assess financial, non-financial and operational impact and legal implications of requested contract changes
- Demonstrate understanding of competitor landscape within the market (e.g., rates; market share; products; provider networks; market intelligence; GeoAccess)
- Present and discuss industry and market trends with internal and/or external groups (e.g., customer groups; brokers; professional associations; providers) in order to facilitate market strategy development and implementation
- Has a solid understanding of provider termination processes and implications
- Seek information from relevant sources to understand market intelligence information
- Evaluates and negotiates contracts in compliance with client contracts, reimbursement structures, and other key process control
- Monitor and/or oversee provider financial performance to identify opportunities to improve performance and/or provider relationship
- Provides leadership to and is accountable for the performance and results through multiple layers of management and senior level leadership
- Pharmacy network contract negotiation to yield strong financial results for Optum Rx
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:
- 5+ years of experience with network contracting or provider relations
- 5+ years of experience with PBM or pharmacy contract management
- Experience with Pharmacy contract pricing & reimbursement modeling (move this to the Required Qualifications section above)
- Experience managing large chain or client experience managing a national chain or national pharmacy chain or national account greater than 5M in revenue
- Experience working in a highly matrixed/cross-functional environment
- Demonstrated understanding of and utilize applicable financial tools and reports (e.g., internal financial models; external reports) to develop rates
- Demonstrated understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes
- Demonstrated understanding of competitor landscape within the PBM market (e.g., rates; market share; products; provider networks; market intelligence; GeoAccess)
- Demonstrates understanding of key pharmacy reimbursement models
- Demonstrated ability to utilize appropriate contract management systems to author and execute contracts and to access supplemental contractual documents
Preferred Qualifications:
- 3+ years of experience developing financial modeling, pharmacy reimbursement modeling, pharmacy market intelligence
- 3+ years working cross functionally with teams including but not limited to, Industry, Network, Client, Clinical, Sales, Analytics, Business Development, Finance
- Experience using Tableau, PowerBi Salesforce, and GeoAccess
- Must be able to accommodate CST or EST work schedule
*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 $112,700 - $193,200 annually based on full-time employment. We comply with all 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 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.
Skills Required
- 5+ years of experience with network contracting or provider relations
- 5+ years of experience with PBM or pharmacy contract management
- Experience with pharmacy contract pricing and reimbursement modeling
- Experience managing large chains, national pharmacy chains, or national accounts greater than $5 million in revenue
- Experience working in a highly matrixed, cross-functional environment
- Ability to use financial tools and reports to develop rates
- Understanding of contract language and its financial, operational, and legal implications
- Understanding of the competitor landscape within the PBM market
- Understanding of key pharmacy reimbursement models
- Ability to use contract management systems to author and execute contracts and access supplemental documents
- 3+ years of experience developing financial modeling, pharmacy reimbursement modeling, or pharmacy market intelligence
- 3+ years working cross-functionally with Industry, Network, Client, Clinical, Sales, Analytics, Business Development, or Finance teams
- Experience using Tableau, Power BI, Salesforce, and GeoAccess
- Ability to accommodate CST or EST work schedules
Optum Compensation & Benefits Highlights
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Parental & Family Support — Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
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Retirement Support — A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
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Equity Value & Accessibility — An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.