at UnitedHealth Group in Schaumburg, Illinois, United States
Job Description
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.
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 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 managing large chain or client experience managing a national chain or national pharmacy chain or national account greater than 5M in revenue
+ 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)
+ Demonstrated ability to utilize appropriate contract management systems to author and execute contracts and to access supplemental contractual documents
+ Experience working in a highly matrixed/cross-functional environment
+ Demonstrates understanding of key pharmacy reimbursement models
Preferred Qualifications:
+ 3+ years 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
+ Experience with Pharmacy contract pricing & reimbursement modeling
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
