Director Pharmacy Value Economics - Remote

Texas Health Institute; Draper, Northern (UT, KY); Hybrid; USD 135,000 - 231,000; Full time

Job summary

Optum is seeking a Director of Pharmacy Value Economics to lead the national measurement, forecasting, and realization of pharmacy value across Optum Health. You will own the value framework, govern methodologies, and collaborate with finance, actuary, and accounting for forecasting and executive reporting.

The role focuses on rebate programs and expanding to total pharmacy value measurement, acting as a dyad with clinical and analytics leadership. Remote work from anywhere in the U.S.

Qualifications

• 8+ years of experience in healthcare, pharmacy, managed care, finance, or related fields.
• 5+ years of direct or matrixed people leadership experience.
• Experience developing or applying healthcare, pharmacy, reimbursement, affordability, or drug economics methodologies.
• Experience developing forecasts, economic evaluation frameworks, and executive business cases.
• Experience designing data models for scalable forecasting and value realization.
• Experience measuring financial performance including forecast accuracy and revenue leakage.
• Experience developing executive dashboards, scorecards, and KPIs.
• Experience leading cross-functional initiatives with clinical, finance, analytics, operations, contracting, and market leadership.
• Ability to communicate with senior leaders and influence decisions through data-driven insights.

Responsibilities

• Own the pharmacy value economics framework across Optum Health, including governance and value realization reporting.
• Lead forecasting methodologies for rebate revenue, value programs, and market expansion.
• Develop financial models and executive business cases to support strategic planning.
• Create executive dashboards and KPIs to inform senior leadership decisions.
• Identify revenue leakage and opportunities to improve value realization.
• Collaborate with clinical, finance, analytics, and market leadership to drive initiatives.

Skills

Healthcare economics

Forecasting

Executive reporting

Cross-functional leadership

Data modeling

Education

PharmD or pharmacist licensure

Tools

Power BI

Tableau

Excel

Financial modeling tools

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 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.

The Director, Pharmacy Value Economics is accountable for leading the national measurement, forecasting, and realization of pharmacy value across Optum Health, with an initial focus on manufacturer-funded programs and rebate economics that support clinically appropriate, evidence-based medication strategies. This role owns the pharmacy value economics framework and leads a team that collaborates with matrixed partners such as finance, actuary, and accounting for forecasting, financial performance measurement, net cost analytics, opportunity sizing, executive value reporting, and value realization governance. The Director translates financial, utilization, and market data into enterprise-level recommendations that balance affordability, access, quality, appropriateness, and sustainable value creation.

While initially focused on rebate programs, this role is designed to lead the evolution of a broader pharmacy value economics capability supporting manufacturer strategy, value product initiatives, affordability programs, and total cost of care improvement. The role operates as a dyad partner to clinical and analytics leadership teams, ensuring insights are grounded in appropriateness, operational feasibility, and enterprise value priorities while establishing consistent methodology, governance, and reporting standards.

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

Primary Responsibilities

• Pharmacy Value Economics Strategy
  • Own the pharmacy value economics framework across Optum Health, including methodology, governance, financial performance standards, and value realization reporting
  • Establish methodologies to measure rebate performance, yield, value realization, and return on investment
  • Lead prioritization and execution of rebate, manufacturer value, and pharmacy affordability opportunities in partnership with clinical, finance, analytics, and market leadership
  • Evaluate net cost effectiveness post rebate with Clinical Pharmacy Insights to ensure recommendations are clinically appropriate, affordability-aligned, and compatible with Optum Health Pharmacy Value & Therapeutics Committee guidance
• Forecasting & Financial Performance
  • Lead national forecasting methodologies for rebate revenue, manufacturer value programs, value product opportunities, and market expansion initiatives
  • Develop financial models and executive business cases that support strategic planning, investment decisions, affordability initiatives, and value realization commitments
  • Monitor forecast accuracy and identify key drivers impacting performance
  • Identify variance between vendor estimates and actual performance, including drivers of financial impact, leakage, and realized value
• Analytics & Insights
  • Own executive dashboards, scorecards, KPIs, and value reporting that inform senior leadership decisions and enterprise performance management
  • Produce actionable insights related to rebate performance, net cost optimization, utilization trends, value capture, and affordability opportunities
  • Translate data and analytic conclusions into concise executive-level narratives, recommendations, and decision support materials
• Revenue Leakage & Opportunity Identification
  • Identify revenue leakage and value capture gaps across rebate and manufacturer-funded programs
  • Quantify opportunity size and prioritize improvement initiatives
  • Drive accountability with operational teams to ensure identified opportunities translate into measurable and sustained realized value
• Industry Intelligence & Market Analysis
  • Monitor trends affecting pharmacy value, including pharmaceutical market dynamics, biosimilar adoption, reimbursement changes, and regulatory developments
  • Assess the impact of initiatives such as Medicare Drug Price Negotiation (MFP), Inflation Reduction Act provisions, and evolving manufacturer strategies
  • Develop scenario analyses and strategic recommendations for leadership
• Value Analytics Expansion
  • Lead measurement and financial performance evaluation of value product initiatives, future manufacturer value opportunities, and affordability initiatives
  • Develop integrated value measurement approaches across clinical, financial, actuarial, healthcare economics, contracting, and operational stakeholders
  • Establish and scale the analytics framework beyond rebates toward total pharmacy value measurement across populations, markets, and lines of business
• People Leadership
  • Lead, coach, and develop a high-performing team responsible for forecasting, analytics, reporting, and financial modeling
  • Establish priorities, performance expectations, and development plans
  • Foster a culture of accountability, innovation, continuous improvement, and data-driven decision making

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

• Relevant Experience: 8+ years of experience in healthcare, pharmacy, managed care, finance, healthcare economics, market access, manufacturer contracting, or rebate management
• People Leadership: 5+ years of direct or matrixed people leadership experience
• Value Economics: Experience developing or applying healthcare, pharmacy, reimbursement, affordability, or drug economics methodologies to support strategic decision-making
• Financial Modeling: Experience developing forecasts, economic evaluation frameworks, value measurement methodologies, sensitivity analyses, and executive business cases
• Data Modeling: Experience designing or overseeing claims, utilization, financial, or economic data models that support scalable forecasting, performance measurement, opportunity sizing, and value realization
• Financial Performance: Experience measuring financial performance, including forecast accuracy, budget variance, value capture, and revenue leakage
• Executive Reporting: Experience developing executive dashboards, scorecards, KPIs, performance measurement frameworks, and value realization reporting
• Cross-Functional Leadership: Experience leading cross-functional initiatives with clinical, finance, analytics, operations, contracting, and market leadership stakeholders
• Analytics Leadership: Experience translating complex healthcare, utilization, financial, claims, or operational datasets into scalable economic models, executive insights, and strategic recommendations
• Executive Communication: Demonstrated ability to communicate with senior leaders and influence decisions through data-driven insights

Preferred Qualifications

• Pharmacy Credentials: PharmD or pharmacist licensure
• Rebate Strategy: Experience with pharmaceutical rebates, preferred product strategies, or value-based programs
• Strategic Analysis: Experience conducting opportunity sizing, scenario analysis, or ROI analysis
• AI-Enabled Analytics: Experience leveraging generative AI, predictive analytics, or automation technologies to improve forecasting, analytic productivity, decision support, or business insights
• BI Tools: Experience developing executive dashboards and performance measurement frameworks using Power BI, Tableau, or comparable business intelligence platforms
• Business segment experience: Experience supporting Medicare Advantage, Medicaid, Commercial, and value-based care populations
• Medical benefit expertise: Working knowledge of medical benefit drugs, specialty pharmaceuticals, infused therapies, biosimilars, and manufacturer-sponsored programs
• Policy Knowledge: Knowledge of pharmaceutical policy, reimbursement, and regulatory trends, including the Inflation Reduction Act and Medicare Drug Price Negotiation Program

*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.

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.