Job Descriptions

Primary Responsibilities:

• Establishes and maintains strong business relationships with Chain, Grocer, PSAO or Specialty pharmacies in support of clients
• 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 to yield strong financial results for Optum Rx

Job Scope and Guidelines:

• Extensive engagement with both internal and external senior leadership to resolve highly complex or unusual business problems that affect major functions or disciplines
• Drives programs that impact financial results through negotiation

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:

• Undergraduate degree or equivalent experience
• Significant experience of management experience in a healthcare contracting related role (Medical/Pharmacy/Pharmaceuticals/ Health Insurance, etc.) overseeing complex relationships with accountability for business results
• Experience interacting with executive leadership
• Experience understanding financials and explaining details

Preferred Qualifications:

• Financial or Analytical qualification
• Experience with large scale negotiations
• Experience with client presentations (verbal and PowerPoint creation)

Skills

Experience

• 6+ years