We’re creating opportunities in every corner of the health care marketplace to improve lives while we’re building careers. And that means continuous career growth opportunities for you. While we support you with the latest tools, advanced training and the combined strength of high caliber co-workers, you can continue on following the path of your life’s best work.(sm)
The VP, Government Strategy, Pharmacy will have an in-depth understanding of the strategy, financing and performance drivers of government programs business in order to support the bid strategy, product development cycle, trend management and alternative payment model development for the segment in support of OptumRx growth and market differentiation. This leader will be accountable for partnering with the growth organization, underwriting, product and data science teams to analyze historical client and industry benchmark data, make recommendations for trend mitigation and affordability initiatives that will drive value for both OptumRx, clients and prospects. This role will be accountable for proactively assessing the regulatory landscape, identifying alternative revenue streams and developing new payment models that will deliver top line growth, aligned incentives with clients and ROI.
This leader will partner with the Optum RX Market President for Health Plans and Market President for Government to partner on solution implementation to ensure effective day to day operations to meet customer requirements.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Product development strategic and financial support inclusive of the following:
- Medicare bid support strategy for OptumRx clients, performing competitive and strategic analysis of formulary, benefit, and network design upon which to support insights and recommendations
- Health Insurance Exchange product strategy to include formulary analysis, risk adjustment quantification, affordability initiatives to drive product and premium decisions and risk selection analysis
- Medicaid product support to formulate and quantify alternative payment models and value-based incentive arrangements for government programs to align incentives, derive incremental spreadsheet value and improve client performance
- Network Strategy - Supports the development of product specific network strategies leveraging analytics, market intelligence and growth objectives
- Model total cost of care - For key populations, model total cost of care trends and the impact of interventions on trends over time/Design and measure performance on risk-based payment models with providers
- Trend and Spend Management - Ensure coordination with medical economics and OptumRx functional teams to provide ongoing information on the utilization and benefit expense changes for the business/Analyses require a working knowledge and synthesis of several leading indicator and claims-based reports as well as benefit and regulatory information that leads to the identification of drivers of adverse trend and or spend
- Communication of Risk Model performance - Communicate benefit expense trends and impacts of various benefit and clinical changes specific to internal and external customers/Facilitate trend reviews at channel & market levels to communicate to stakeholders the status of accounts and progress on strategies/Work with Forecast team to ensure forecast trends align with past and future expectations
- Lead and Develop People - Responsible to create an environment oriented to trust, open communication, creative thinking and cohesive team effort/Leader will leverage diversity and inclusion and drive employee engagement
- Determine impact of changes in benefits, reimbursement rates and clinical programs
- Partner cross functionally to identify mitigation opportunities
- Provide information and guidance on retrospective and prospective utilization and cost trends
- Serve as expert for new product development and RFPs
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.
- Bachelor’s degree
- 10+ years of relevant pharmacy industry experience including experience in insurance product management, healthcare benefit plan design and implementation, behavioral benefit plan design and implementation and/or underwriting and pricing
- Experience supporting large book of business with multiple P&Ls and products
- Experience in Medicaid, Medicare and Health Insurance Exchange government programs
- Demonstrated healthcare industry knowledge in a combination of the following areas: healthcare benefits and services; sales and customer account management; underwriting and actuarial services; emerging healthcare trends
- Experience utilizing exceptional executive communication skills and proven ability to influence thinking of C-Suite executives
- Experience delivering results with large-scale, cross-functional teams in highly matrixed organizations
- Experience managing and prioritizing multiple projects to ensure their quality and on-time delivery
- Graduate degree (MBA, MHA)
- Actuarial background; certification
- Consulting experience or experience leading broad and high visibility problem analysis and product solutioning with a diverse set of stakeholders
- Active relationships with external stakeholder groups/organizations that are oriented to healthcare, medical, social, policy, or other focal areas that are insightful for population health related products
To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado/Connecticut/Nevada residents is $134,200 to $257,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.