The Director, Rebate Strategy and Operations owns the enterprise operating model, governance, financial controls, and scalable execution strategy for manufacturer-funded medical benefit rebate programs across Optum Health. This role is accountable for end-to-end rebate value capture, including eligibility determination, rebate qualification, drug attestation, program administration, reconciliation, compliance, audit readiness, leakage mitigation, and measurable financial performance.
This leader ensures eligible manufacturer value is accurately identified, submitted, tracked, collected, reconciled, and reported, while partnering with Pharmacy, Finance, Health Care Economics, Analytics, Contracting, Industry Relations, Compliance, and Market Leadership.
Success requires strong working knowledge of medical benefit drugs, manufacturer rebate programs, reimbursement, qualification requirements, financial controls, and operational governance, with the ability to effectively lead cross-functional teams and leverage clinical, financial, analytic, and operational expertise across the organization. The Director leads a team focused on execution, eligibility governance, dispute resolution, compliance, process improvement, and scalable growth of manufacturer-funded programs.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Enterprise Rebate Strategy & Operating Model
- Own the enterprise operating model and execution strategy for manufacturer-funded rebate programs across supported lines of business
- Establish scalable operating models, policies, procedures, controls, and governance structures
- Ensure timely, accurate, compliant, and financially accountable execution of rebate-related operational activities
- Develop executive-level performance metrics and reporting to monitor program effectiveness, operational health, value realization, and rebate leakage risk
- Rebate Eligibility & Attestation Governance
- Set strategic direction for portfolio and drug-level attestation governance, including eligibility standards, qualification methodologies, and portfolio inclusion criteria
- Accountable for governance over manufacturer rebate eligibility requirements, program rules, and operational interpretation, ensuring consistent application across teams and programs
- Oversee decision frameworks for product mapping, HCPCS/J-code alignment, NDC crosswalks, biosimilar relationships, and product attribution methodologies
- Lead cross-functional alignment with HCE, Clinical, Analytics, and Contracting to ensure eligible products are identified, governed, and supported for claims submission
- Manufacturer Program Administration & Operational Readiness
- Oversee manufacturer and vendor operational relationships, submission processes, supporting documentation, and program requirements
- Lead implementation of new rebate opportunities, program expansions, operating model changes, and operational onboarding
- Ensure enterprise readiness for new products, manufacturers, reimbursement models, value arrangements, and rebate entitlement requirements
- Compliance, Controls & Operational Excellence
- Ensure compliance with manufacturer agreements, internal governance requirements, documentation standards, and audit expectations
- Lead audit preparation, response activities, corrective action implementation, and risk mitigation
- Drive continuous improvement, automation, standardization, and scalability initiatives
- Establish best practices and governance routines that support long-term program growth
- Value Capture, Reconciliation & Financial Accountability
- Own rebate tracking, payment reconciliation, discrepancy resolution, dispute escalation, and value realization processes
- Partner with Finance, Accounting, and Economics teams to strengthen forecasting, accrual support, realized value reporting, and reconciliation controls
- Identify and resolve operational, data, vendor, or process barriers that may impact rebate capture, collection rates, and financial performance
- Drive measurable improvement in collection performance, reduce value leakage, and maintain clear accountability for financial outcomes
- Cross-Functional & People Leadership
- Lead, coach, and develop a high-performing team responsible for rebate operations, qualification governance, financial controls, and manufacturer program administration
- Establish strategic priorities, performance expectations, accountability routines, succession planning, and individual development plans
- Collaborate with Pharmacy, Finance, HCE, Contracting, Industry Relations, Compliance, Analytics, and Market Leadership
- Influence enterprise decision-making through executive-ready insights, operational recommendations, business case development, and cross-functional alignment
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 pharmaceutical rebates, manufacturer programs, health plan or PBM operations, specialty pharmacy, medical benefit drug operations, healthcare finance, or related healthcare value functions
- 5+ years of people leadership experience, including leading teams responsible for complex operations, governance, controls, financial performance, or transformation initiatives
- Experience owning operating models, governance structures, controls, and execution processes across complex, cross-functional programs
- Experience leading programs with measurable financial accountability, including value capture, forecasting support, reconciliation, issue resolution, risk mitigation, and performance management
- Experience leading teams through operational change, process standardization, scalable growth, and sustained performance improvement
- Demonstrated ability to influence senior leaders, communicate operational and financial risk, develop business cases, and drive enterprise alignment.
- Demonstrated ability to lead through ambiguity, resolve enterprise issues, and align Finance, Analytics, Clinical, Contracting, Compliance, Operations, and other stakeholders
Preferred Qualifications:- PharmD or pharmacist licensure.
- Experience with portfolio qualification, drug attestation, rebate eligibility determination, manufacturer audit support, and dispute resolution
- Experience interpreting manufacturer contract language and translating requirements into operational processes
- Experience with HCPCS coding, J-codes, NDC crosswalks, product mapping, and utilization-based rebate methodologies
- Experience supporting Medicare Advantage, Medicaid, Commercial, and value-based care populations
- Experience with workflow optimization, automation, rebate value leakage analysis, forecasting, accrual support, or financial performance measurement
- Working knowledge of medical benefit drugs, specialty pharmaceuticals, infused therapies, biosimilars, and manufacturer-sponsored programs
*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.
