PBM Specialty Operations & Strategy Lead - Remote

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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Specialty Operations & Strategy Lead is responsible for leading specialty pharmacy operations and pricing oversight for HealthTrust, ensuring programs and services are delivered effectively, financial performance is actively managed, and client objectives are achieved. The role also contributes to specialty strategy by identifying operational, pricing, and market opportunities that support the evolving needs of HealthTrust.

The role is accountable for operational performance across the specialty pharmacy portfolio, including service delivery, pricing governance, financial monitoring, issue resolution, and continuous improvement. This position works closely with HealthTrust, Optum Specialty, and Optum Rx stakeholders to ensure specialty products, programs, and services deliver clinical value, competitive pricing, a solid member and provider experience, and achievement of client program objectives.

Working across operations, pricing, contracting, clinical, analytics, product, and account management teams, this individual provides day-to-day leadership, establishes accountability, monitors performance, and drives timely execution of specialty initiatives. The role requires a deep understanding of specialty pharmacy operations, pricing methodologies, financial drivers, and emerging market dynamics, along with the ability to lead complex cross-functional work and build trusted client and executive relationships.

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

Primary Responsibilities: 

• Lead the operational performance and delivery of specialty pharmacy services and programs supporting HealthTrust
• Provide oversight of specialty pricing, financial performance, guarantees, and related contractual commitments
• Establish governance, operating routines, and accountability across HealthTrust, Optum Specialty, and Optum Rx teams
• Monitor service levels, operational metrics, pricing results, and client outcomes; identify risks and lead corrective actions
• Partner with pricing, underwriting, contracting, finance, and analytics teams to evaluate specialty cost drivers and support competitive, sustainable pricing
• Lead issue resolution and escalation management for complex specialty operational, pricing, and service matters
• Collaborate with clinical, product, account management, and operations teams to ensure successful implementation and execution of specialty initiatives
• Drive continuous improvement efforts that strengthen operational efficiency, service quality, financial performance, and the HealthTrust partnership
• Serve as the primary specialty pharmacy subject matter expert and operational advisor to HealthTrust leadership and stakeholders
• Lead business reviews, operational planning sessions, pricing discussions, and client presentations
• Assess specialty pharmacy trends, pipeline therapies, biosimilars, gene therapies, and regulatory developments for operational and financial impact
• Contribute to specialty strategy and roadmap decisions by bringing forward client needs, performance insights, market intelligence, and practical recommendations

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 progressive experience within the healthcare, pharmacy benefit management (PBM), specialty pharmacy, managed care, or healthcare consulting industries
• 3+ years of experience in specialty pharmacy operations, pricing, financial performance, client service, or related cross-functional programs
• Demonstrated expertise in specialty pharmacy operations, products, pricing, clinical management programs, and market trends
• Proven experience managing operational performance, resolving complex issues, and communicating with executive stakeholders and large healthcare clients
• Demonstrated solid understanding of specialty drug management, pricing and reimbursement models, utilization trends, manufacturer strategies, and emerging therapies
• Experience leading complex, cross-functional initiatives and influencing outcomes across operations, pricing, contracting, finance, clinical, product, and account management teams
• Demonstrated exceptional executive communication, presentation, relationship management, and negotiation skills
• Demonstrated solid analytical and financial acumen with the ability to translate operational and pricing data into actionable business recommendations

Preferred Qualifications: 

• Licensed pharmacist 
• Experience supporting large employer, health system, GPO, or national healthcare client relationships
• Experience with specialty pharmacy pricing, financial guarantees, or performance oversight
• Demonstrated knowledge of biosimilars, gene therapies, rare disease management, and value-based specialty care models
• Experience presenting operational performance, pricing results, and recommendations to executive leadership and client stakeholders
• Experience working in highly matrixed organizations and managing multiple operational and strategic priorities simultaneously

Key Competencies:

• Specialty Operations Leadership
• Pricing and Financial Oversight
• Specialty Pharmacy Expertise
• PBM Industry Knowledge
• Operational Governance and Accountability
• Client Relationship Management
• Executive Communication and Influence
• Business and Financial Acumen
• Cross-Functional Collaboration
• Issue Resolution and Continuous Improvement
• Strategic Thinking
• Results Orientation

*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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.