Senior Director, Payer Relationships – 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 to start Caring. Connecting. Growing together.

 

The Senior Director of Payer Relationships manages our payer relationships in a specific region of the country for external payer clients. You will lead, develop, maintain, and enhance business relationships with national and regional accounts to deliver access and coverage that accomplishes company objectives for Optum Infusion, Optum Specialty, Optum Home Delivery and Genoa Healthcare pharmacies. The primary focus is on payer medical and pharmacy contracting. To be successful in this role, you will need to be a strategic decision maker and influencer in relations, contract negotiations, and delivery of clinical and economic value. It requires strong networking and relationship-building capabilities with key account clinical and economic influencers to identify and impact potential opportunities. 

 

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

 

Primary Responsibilities:

• Serves as the regional strategic leader between all payers; develops a comprehensive business plan which includes objectives and goals, maintains an accurate account profile of all key customer contacts and an overall profile of the account including competitive messaging and contracting, key business priorities/insights, unique or innovative contract offerings, and sphere of influence/associations within the payer marketplace
• Understands the customers’ business needs and delivers product value propositions and key resources in order to secure and grow/maintain product portfolio and indication access
• Demonstrates expertise as the subject matter expert on the assigned key payer accounts and serves in that capacity when collaborating with internal Optum stakeholders
• Specializes in the market landscape, disease state, product clinical value, competition value, pricing, payer and provider pathway impact and patient financial responsibilities and assistance programs impacting market access for Optum Pharmacies; uses this expertise to appropriately build access through impact on policies, pathways, guidelines, and contracts
• Provides profitable access for Optum pharmacy portfolio across all lines of business—Commercial, Medicare, Medicaid, and Federal (VA, DoD, TriCare) payer segments as assigned
• Partners with key internal Optum Pharmacy stakeholders as appropriate to direct and execute strategic implementation of all company and customer initiatives related to payer policy impact for market access leadership
• Leads partnerships with select stakeholders (pharmacy operations, sales, clinical, marketing) in the development and communication of payer access pull through strategies and communicates and collaborates effectively and consistently to support key payer account knowledge and service access opportunities/challenges
• Communicate key payer access changes and pulls through opportunities and strategic planning to senior leadership and key stakeholders during business reviews
• Collaborates with key cross-functional stakeholders to develop strategic revenue access opportunities for national and regional implementation
• Coordinates and manages the entire process for assigned national/regional payers at various stages of development and growth; collaborates with internal stakeholders to identify and facilitates pull through initiatives, tracks performance, and increases utilization of Optum Pharmacies
• Partners with contract pricing strategy team to conduct financial modeling/analysis that supports sound business cases and develops appropriate pricing contracting steering committee requests in conjunction with contracting managers to support those key business cases
• Attends key sales and market access meetings to deliver payer account updates and insights; attends national/regional payer conferences/conventions to engage with priority account customers
• Develops and maintains contacts within the industry to provide key payer account insights and information; understands the competitive landscape and gathers information on specific laws, regulations, or legislation
• Performs routine administrative duties and special assignments properly and on a timely basis while maintaining compliance with all United Health Group/Optum policies and procedures

 

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:

• 7+ years of payer contracting experience and/or management experience
• Solid understanding of benefit design and economics associated with medical and pharmacy benefits for Medicare, Commercial and Medicaid reimbursement
• Knowledge of Centers for Medicare and Medicaid Services (CMS) policies and processes
• Excellent interpersonal skills, including networking, influencing, negotiation, presentation, and written and verbal communication
• Proven ability to think strategically and develop, execute, and monitor strategic business plans
• Demonstrated ability to engage, influence, and lead cross-functional teams
• Ability to travel up to 20%, may include some weekends due to conferences

 

Preferred Qualifications:

• 5+ years of specialty pharmacy or pharmaceutical experience 

 

Key Leadership Practices:

• Solid executive skillset for vision and strategy formulation
• Demonstrated ability to create and leverage innovation
• Proven track record of applying enterprise insight
• Ability to lean into uncertainty and ambiguity
• Achievement drive

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. 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.

 

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.