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.
Optum Rx, a UnitedHealth Group company, with over 24,000 employees globally, specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. Our goal is to deliver high-quality, integrated services to promote optimal outcomes, superior savings and outstanding client and consumer experiences. We make healthier happen by creating smarter health care connections to help more than 65 million consumers nationwide realize improved care, lower costs, and a better overall experience. This is a place like no other and where you'll do your life's best work.
OptumRx is looking for a curious, adaptable, and self-motivated professional to join our Network Pricing team in a hybrid role that combines PBM network pricing expertise with transformation delivery. This role will support prescription drug pricing analysis, client performance management, and financial modeling while also contributing to process improvement, data product adoption, operating model change, and cross-functional transformation initiatives. The person in this role will build a solid understanding of PBM pricing fundamentals, claims and contract data flows, analytical tools, and the systems used to support pricing decisions. Solid communication and stakeholder management skills are essential, as this role partners closely with Network Pricing, Data Science, Operations and technology teams to deliver measurable business outcomes.
Supports PBM network pricing, client performance management, and transformation initiatives through financial modeling, claims and contract analysis, reporting, process improvement, and cross-functional delivery. Conducts pricing and unit cost analysis in support of pharmacy network strategies, client guarantees, contract valuation, and operational decision-making. Partners with business, analytics, and technology teams to improve tools, data products, workflows, and governance practices that support scalable and accurate pricing operations.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Lead complex PBM network pricing analysis, financial modeling, scenario evaluation, and unit cost initiatives supporting pharmacy network strategy, client guarantee performance, contract valuation, and executive decision-making
- Serve as a senior subject matter expert for claims, contract, pricing, reimbursement, MAC, network, and utilization data, translating complex findings into clear recommendations and business actions
- Own or lead cross-functional workstreams that improve pricing tools, data products, governance, operating model processes, reporting capabilities, and scalable business controls
- Partner with senior stakeholders across Network Pricing, Data Science, Operations, Product, Technology, Finance, and other business teams to shape priorities, define requirements, resolve issues, and deliver measurable outcomes
- Drive transformation delivery by identifying process gaps, automation opportunities, control weaknesses, and operational risks, then leading practical solutions from discovery through implementation and adoption
- Provide analytical leadership on pricing anomalies, client performance drivers, pharmacy network trends, reimbursement changes, and claims data issues, including root-cause analysis and recommended remediation
- Lead Agile delivery activities for pricing-related capabilities, including backlog refinement, prioritization, requirement definition, user acceptance testing, release readiness, stakeholder communication, and adoption tracking
- Mentor and guide less experienced team members by sharing pricing knowledge, analytical methods, business context, and best practices for stakeholder engagement and delivery execution
- Prepare executive-ready materials, decision summaries, action plans, and status updates that clearly communicate risks, trade-offs, recommendations, and progress against business priorities
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:
- 5+ years of analytical experience in financial analysis, health care pricing, PBM network pricing, network management, health care economics, pharmacy benefit management, or a related discipline
- 5+ years of experience developing, maintaining, or leading financial models, analytical tools, spreadsheets, dashboards, or reporting outputs used to support pricing strategy and business decisions
- 3+ years of experience leading process improvement, business transformation, operational change, product delivery, or technology-enabled initiatives
- Demonstrated experience using claims, contract, reimbursement, pricing, utilization, or network data to identify business insights, risks, and improvement opportunities
- Proven ability to lead cross-functional initiatives, manage competing priorities, influence stakeholders, and drive outcomes in a complex matrixed environment
- Proven understanding of Agile delivery practices, including requirements definition, backlog management, prioritization, testing, release planning, and adoption support
- Proven excellent executive communication skills, with the ability to summarize complex analysis, business impacts, risks, and recommendations for senior leaders
- Proven solid analytical, critical thinking, problem-solving, and decision-making skills, with the ability to operate independently in a fast-paced environment
Preferred Qualifications:
- Product Owner, Scrum Master, Project Management, Business Analysis, Lean/Six Sigma, or similar certification
- Advanced experience in PBM, pharmacy network pricing, reimbursement strategy, contract valuation, MAC pricing, client guarantees, claims analysis, or health care economics
- Experience leading transformation, product, automation, governance, or operating model initiatives in a pricing, analytics, operations, or technology environment
- Experience mentoring analysts, consultants, or cross-functional partners on pricing concepts, analytical approaches, process standards, or delivery practices
- Experience preparing executive-level presentations, business cases, decision papers, or strategic recommendations
*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 to $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.