Associate Director Network Contracting - Remote

Optum; Schaumburg (IL); On-site; USD 113,000 - 193,000; Full time

Benefits offered by this job

Remote work within US

Job summary

Optum is a global health services company looking for a senior contract professional to drive network contracting across pharmacy clients. You will negotiate with chains, Grocers, PSAOs, and specialty pharmacies, ensuring favorable terms and compliance with client agreements.

The role emphasizes financial modeling, market intelligence, and leadership across matrixed teams, with a strong focus on delivering value for Optum Rx and its clients.

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.
• Experience managing large chain or national account >$5M in revenue.
• Experience in a highly matrixed environment.
• Demonstrated ability to use financial tools/reports to develop rates.
• Understanding of contract language to assess financial/operational impact.

Responsibilities

• Establishes and maintains strong business relationships and leads negotiations with pharmacies and clients.
• Analyze contract language for financial, non-financial, and legal implications of changes.
• Explain market trends to support strategy development and implementation.
• Understand provider termination processes and implications.
• Monitor provider financial performance to identify improvement opportunities.
• Lead and be accountable for performance through multiple management levels.
• Negotiate pharmacy network contracts to achieve strong financial results.

Skills

Contract negotiations

PBM knowledge

Contract pricing

Market analysis

Cross-functional collaboration

Financial modeling

Contract management systems

Tools

Tableau

Power BI

Salesforce

GeoAccess

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 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.