Latest job information from UnitedHealth Group for the position of Senior Director, Network Pricing Strategy. If the Senior Director, Network Pricing Strategy vacancy in Letterkenny matches your qualifications, please submit your latest application or CV directly through the updated Jobkos job portal.
Please note that applying for a job may not always be easy, as new candidates must meet certain qualifications and requirements set by the company. We hope the career opportunity at UnitedHealth Group for the position of Senior Director, Network Pricing Strategy below matches your qualifications.
Job Description
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
About the Role:
The Senior Director, Network Pricing Strategy is a strategic leader within OptumRx's Network team, responsible for delivering network margin performance, regulatory alignment and related strategies across all lines of business, clients & pharmacies.
You will lead a team of business and data analysts and be responsible for setting the direction for network pricing to navigate the quickly changing regulatory landscape and defining pricing strategies to transform the network pricing model. You will also evolve how network value is currently analyzed, optimized and delivered. Success in this role depends on deep collaboration with Finance, Legal, Underwriting and Network colleagues, ensuring strategies are aligned, risks are managed, and opportunities are captured in an efficient and timely manner.
Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny office and telecommuting from a home-based office in a hybrid work model.
Key Responsibilities:
Network Strategic Leadership & Innovation
Partner closely with regulatory, legal and other network teams to define and document business interpretations of state regulations and capture key stakeholder feedback on the same
Develop pricing strategies which navigate these regulations, mitigate financial impacts and present proposals to executives to gain leadership alignment. Partner with provider and client contracting/ underwriting teams to ensure contracting is aligned. Support and oversee implementations accordingly and work with finance partners to appropriately forecasts for impacts
Develop pricing strategies and provide strategic and analytical support for transformation initiatives across all lines of business (Commercial, Medicare, Medicaid)
Develop pricing strategies to drive incremental network value to support gap fill
Leverage of-the-day capabilities to better understand & derive opportunities from our existing client agreements; design and evaluate novel client contracting approaches, motivated by findings of same
Lead the development and execution of network strategies using AI-powered analytics, automation, and innovative models
Work with Underwriting to appropriately account for state regulations and integrate desired network strategies into pricing and risk models
Network Margin Gap Fill & Reporting
Responsibility for guiding the delivery of network margin stretch targets, driving accountability with network teams
Partner closely with Finance to align network performance with our overarching financial objectives
Cross-reference client and pharmacy performance data to inform strategic decisions
Lead our Retail Gap Fill agenda - initiative pipeline, risk mitigation, alignment on progress & communication of same
Network Analytics
Analyze the impact of state and federal regulations specific to Network, communicating risks & viable paths forward which minimize risk to the enterprise
Collaborate with Legal, Operations and Underwriting to represent, implement & maintain compliant, strategic pricing frameworks which align to regulatory demands
Support with network queries from Market Conduct Exams and other regulatory audits
Develop a network margin intelligence suite enabling validation, providing real time analysis of key network margin drives and enabling validation of all budget and forecast assumptions
Analyze utilization and mix impacts on network performance, both prior & future
Develop trend reporting on key market benchmarks e.g. PAC, NADAC, WAC, AWP
Support ad hoc analyses with scalable, intelligent analytics platforms
Support operations teams with providing strategic direction on implementations
Client Contract Management
Client accrual and performance reporting and forecasts
Client over and under performance forecasts for forecast cycles
Collate contractual blockers on key clients and report on related financial impacts, partnering with Underwriting to proactively tackle these items on a medium-term basis
Implement robust process for client margin prioritization, integrating to pricing tools WFM
Collate and prioritize all pricing tool requirements from CCM team and work with product managers to enhance the tools roadmap with a supporting capital backlog
Responsibility for UHC E&I and M&R reporting, analytics and pricing activities
Leverage AI and automation to review client contracts at scale to identify incremental margin opportunities
You will 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 providing development for other roles you may be interested in.
Required Qualifications:
Proven experience in strategy, analytics, or related fields
Demonstrated success in applying automation, and innovation to strategic challenges
Demonstrable solid collaboration skills with peers, team members & senior leadership
Proven thorough and demonstrable understanding of network margin economics
Demonstrated excellent leadership, communication, and problem-solving capabilities
Proven ability to work cross functionally and gain alignment on complex strategies from leaders in different areas of the business each with different goals and motivations
Understanding of healthcare/pharmacy networks and client contracting is advantageous, but not essential
Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.
After reading and understanding the criteria and minimum qualification requirements explained in the job information Senior Director, Network Pricing Strategy at the office Letterkenny above, immediately complete the job application files such as a job application letter, CV, photocopy of diploma, transcript, and other supplements as explained above. Submit via the Next Page link below.
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