Director Pharmacy Value Economics - Remote

UnitedHealth Group•Draper, UT

9h•$134,600 - $230,800•Remote

About The Position

The Director, Pharmacy Value Economics is accountable for leading the national measurement, forecasting, and realization of pharmacy value across Optum Health, with an initial focus on manufacturer-funded programs and rebate economics that support clinically appropriate, evidence-based medication strategies. This role owns the pharmacy value economics framework and leads a team that collaborates with matrixed partners such as finance, actuary, and accounting for forecasting, financial performance measurement, net cost analytics, opportunity sizing, executive value reporting, and value realization governance. The Director translates financial, utilization, and market data into enterprise-level recommendations that balance affordability, access, quality, appropriateness, and sustainable value creation. While initially focused on rebate programs, this role is designed to lead the evolution of a broader pharmacy value economics capability supporting manufacturer strategy, value product initiatives, affordability programs, and total cost of care improvement. The role operates as a dyad partner to clinical and analytics leadership teams, ensuring insights are grounded in appropriateness, operational feasibility, and enterprise value priorities while establishing consistent methodology, governance, and reporting standards.

Requirements

8+ years of experience in healthcare, pharmacy, managed care, finance, healthcare economics, market access, manufacturer contracting, or rebate management
5+ years of direct or matrixed people leadership experience
Experience developing or applying healthcare, pharmacy, reimbursement, affordability, or drug economics methodologies to support strategic decision-making
Experience developing forecasts, economic evaluation frameworks, value measurement methodologies, sensitivity analyses, and executive business cases
Experience designing or overseeing claims, utilization, financial, or economic data models that support scalable forecasting, performance measurement, opportunity sizing, and value realization
Experience measuring financial performance, including forecast accuracy, budget variance, value capture, and revenue leakage
Experience developing executive dashboards, scorecards, KPIs, performance measurement frameworks, and value realization reporting
Experience leading cross-functional initiatives with clinical, finance, analytics, operations, contracting, and market leadership stakeholders
Experience translating complex healthcare, utilization, financial, claims, or operational datasets into scalable economic models, executive insights, and strategic recommendations
Demonstrated ability to communicate with senior leaders and influence decisions through data-driven insights

Nice To Haves

PharmD or pharmacist licensure
Experience with pharmaceutical rebates, preferred product strategies, or value-based programs
Experience conducting opportunity sizing, scenario analysis, or ROI analysis
Experience leveraging generative AI, predictive analytics, or automation technologies to improve forecasting, analytic productivity, decision support, or business insights
Experience developing executive dashboards and performance measurement frameworks using Power BI, Tableau, or comparable business intelligence platforms
Experience supporting Medicare Advantage, Medicaid, Commercial, and value-based care populations
Working knowledge of medical benefit drugs, specialty pharmaceuticals, infused therapies, biosimilars, and manufacturer-sponsored programs
Knowledge of pharmaceutical policy, reimbursement, and regulatory trends, including the Inflation Reduction Act and Medicare Drug Price Negotiation Program

Responsibilities

Own the pharmacy value economics framework across Optum Health, including methodology, governance, financial performance standards, and value realization reporting
Establish methodologies to measure rebate performance, yield, value realization, and return on investment
Lead prioritization and execution of rebate, manufacturer value, and pharmacy affordability opportunities in partnership with clinical, finance, analytics, and market leadership
Evaluate net cost effectiveness post rebate with Clinical Pharmacy Insights to ensure recommendations are clinically appropriate, affordability-aligned, and compatible with Optum Health Pharmacy Value & Therapeutics Committee guidance
Lead national forecasting methodologies for rebate revenue, manufacturer value programs, value product opportunities, and market expansion initiatives
Develop financial models and executive business cases that support strategic planning, investment decisions, affordability initiatives, and value realization commitments
Monitor forecast accuracy and identify key drivers impacting performance
Identify variance between vendor estimates and actual performance, including drivers of financial impact, leakage, and realized value
Own executive dashboards, scorecards, KPIs, and value reporting that inform senior leadership decisions and enterprise performance management
Produce actionable insights related to rebate performance, net cost optimization, utilization trends, value capture, and affordability opportunities
Translate data and analytic conclusions into concise executive-level narratives, recommendations, and decision support materials
Identify revenue leakage and value capture gaps across rebate and manufacturer-funded programs
Quantify opportunity size and prioritize improvement initiatives
Drive accountability with operational teams to ensure identified opportunities translate into measurable and sustained realized value
Monitor trends affecting pharmacy value, including pharmaceutical market dynamics, biosimilar adoption, reimbursement changes, and regulatory developments
Assess the impact of initiatives such as Medicare Drug Price Negotiation (MFP), Inflation Reduction Act provisions, and evolving manufacturer strategies
Develop scenario analyses and strategic recommendations for leadership
Lead measurement and financial performance evaluation of value product initiatives, future manufacturer value opportunities, and affordability initiatives
Develop integrated value measurement approaches across clinical, financial, actuarial, healthcare economics, contracting, and operational stakeholders
Establish and scale the analytics framework beyond rebates toward total pharmacy value measurement across populations, markets, and lines of business
Lead, coach, and develop a high-performing team responsible for forecasting, analytics, reporting, and financial modeling
Establish priorities, performance expectations, and development plans
Foster a culture of accountability, innovation, continuous improvement, and data-driven decision making