Senior Director, Network Pharmacy Contracting - Remote

UnitedHealth Group; Eden Prairie (MN); Remote; USD 124,000 - 240,000; Full time

Job summary

Join a forward-thinking organization dedicated to improving health outcomes through innovative pharmacy network strategies. As a Vice President, you will lead efforts in developing competitive pharmacy networks, managing complex contracts, and ensuring cost-effective solutions for clients. This role offers the unique opportunity to influence healthcare delivery on a national scale while working in a flexible, remote environment. Embrace the challenge of driving strategic initiatives that enhance provider relationships and improve patient care. Your leadership will be pivotal in shaping the future of healthcare delivery and equity.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• 8+ years in healthcare contracting with a focus on complex relationships.
• Experience leading teams and managing budgets effectively.

Responsibilities

• Develop and manage pharmacy networks for competitive access.
• Negotiate contracts and assess financial impacts on business.

Skills

Healthcare Contracting

Financial Modeling

Negotiation Skills

Team Leadership

Market Analysis

Education

Bachelor's Degree in Business or Healthcare

MBA or Master's Degree

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've been building towards this. We've been building towards you. The health care system needs are evolving at a fast clip and innovators like UnitedHealth Group are playing a lead role. New models of care and new networks of providers are emerging now to better serve patients and communities. Here's where you come in. As a Vice President within our network pharmacy contracting team, you'll guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

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, ensuring the network composition includes an appropriate distribution of provider specialties and competitive rates
• Develops the pharmacy networks yielding a geographically competitive, broad and focused access, that achieves objectives for cost performance and trend management producing an affordable and predictable product for customers and business partners
• 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 (e.g., COB data; publications; government agencies; providers; provider trade associations) 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 and product support and development of geographically competitive, broad and focused access networks
• Provide leadership to a high performing team to deliver their life’s best work

Job Scope and Guidelines:

• Develops, translates and executes strategies or functional/operational objectives for a region, line of business, or major portion of a business segment functional area
• Extensive engagement with both internal and external senior leadership
• Directs others to resolve highly complex or unusual business problems that affect major functions or disciplines
• Drives programs that impact markets of customers and consumers
• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
• Develop and execute strategies for a function or discipline that span a large business unit or multiple markets/sites
• Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
• Direct others to resolve business problems that affect multiple functions or disciplines
• Direct work that impacts entire functions and/or customer accounts (internal or external)

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:

• 8+ years of experience in a healthcare contracting related role (Medical/Pharmacy/Pharmaceuticals, etc.) overseeing complex relationships with accountability for business results
• 5+ years of pharmacy or PBM contract management experience.
• 5+ years of experience developing product pricing and utilizing financial modeling in making rate decisions
• 3+ years of experience developing and managing a medical cost and administrative budget
• Extensive experience developing pricing & utilizing financial modeling in making rate decisions
• Experience interacting with executive leadership
• Experience leading a team of direct reports
• Experience understanding financials and explaining details

Preferred Qualifications:

• Experience with large scale negotiations (min 2B/contract or greater)
• Experience with client presentations (verbal and PowerPoint creation)
• Sales experience

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

The salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al 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.

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.