This role will be responsible for expanding medical payer access for Optum Specialty Pharmacy (OSP) through the development, negotiation, implementation, and management of medical benefit contracts. The position will support strategic growth initiatives by identifying access gaps, prioritizing payer opportunities, and driving execution of contracting strategies that increase covered lives, improve market access, and support revenue growth.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Lead efforts to expand OSP participation with targeted medical payers and health plans
- Identify and prioritize contracting opportunities using medical access analytics, OON reporting, market intelligence, and revenue opportunity assessments
- Develop and execute contracting strategies designed to increase patient access and improve reimbursement economics
- Lead negotiations, contract implementation activities, and ongoing payer relationship management for medical benefit agreements
- Collaborate with Finance, Operations, Account Management, Network Management, Legal, and Compliance to support medical contracting initiatives
- Monitor contract performance and identify opportunities for optimization, expansion, and enhanced payer partnerships
- Support achievement of enterprise growth objectives through increased medical payer access and diversification of the payer portfolio
- Maintain awareness of evolving market trends, alternative access models, and competitive dynamics impacting specialty pharmacy access
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:- 3+ years of experience in managed care, healthcare payer contracting, provider network management, specialty pharmacy, PBM, infusion, or related healthcare field
- Experience negotiating and managing payer, provider, or healthcare-related contractual agreements
- Experience working with health plans, PBMs, employers, TPAs, provider organizations, or integrated delivery systems
- Knowledge of medical and pharmacy benefit structures, reimbursement methodologies, and network access strategies
- Demonstrated ability to build and maintain relationships with internal and external stakeholders
Preferred Qualifications:- Proficiency with Microsoft Office applications, including Excel and PowerPoint
- Demonstrated ability to manage multiple priorities in a fast-paced environment
- Demonstrated solid analytical and problem-solving skills with the ability to evaluate business opportunities and financial impact
- Demonstrated solid written and verbal communication skills, including presentation and negotiation capabilities
Success Profile- The ideal candidate will bring a blend of:
- Managed care expertise
- Medical contracting and network development experience
- Specialty pharmacy or pharmacy care services knowledge
- Strategic relationship management
- Consultative sales and negotiation skills
- Analytical decision-making capability
- Ability to identify and execute growth-oriented payer access opportunities
*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 $91,700 - $163,700 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.
