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UnitedHealth Group

Strategic Medical Contract Leader - Remote

Posted a day ago
$91700 - $163K per year
2-5 years experience
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AI Summary

The role involves expanding medical payer access for Optum Specialty Pharmacy through the development, negotiation, and management of medical benefit contracts. You will identify access gaps, prioritize payer opportunities, and collaborate with cross-functional teams to drive execution of contracting strategies.

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.

 

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.


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.

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