PBM Specialty Operations & Strategy Lead - Remote
About The Position
The Specialty Operations & Strategy Lead leads specialty pharmacy operations and pricing oversight for HealthTrust. The role ensures services are delivered effectively, financial performance is actively managed, and client objectives are achieved, while contributing to specialty strategy by identifying operational, pricing, and market opportunities. The position is accountable for operational performance across the specialty pharmacy portfolio, including service delivery, pricing governance, financial monitoring, issue resolution, and continuous improvement. It works with HealthTrust, Optum Specialty, and Optum Rx stakeholders to ensure specialty products, programs, and services deliver clinical value, competitive pricing, a strong member and provider experience, and achievement of client program objectives. Working across operations, pricing, contracting, clinical, analytics, product, and account management teams, the lead provides day-to-day leadership, establishes accountability, monitors performance, and drives execution of specialty initiatives. The role requires deep knowledge of specialty pharmacy operations, pricing methodologies, financial drivers, and market dynamics, along with the ability to lead complex cross-functional work and build trusted client and executive relationships. The position is remote within the United States.
Requirements
- At least 3 years of progressive experience in healthcare, pharmacy benefit management (PBM), specialty pharmacy, managed care, or healthcare consulting.
- At least 3 years of experience in specialty pharmacy operations, pricing, financial performance, client service, or related cross-functional programs.
- Expertise in specialty pharmacy operations, products, pricing, clinical management programs, and market trends.
- Experience managing operational performance, resolving complex issues, and communicating with executive stakeholders and large healthcare clients.
- Understanding of specialty drug management, pricing and reimbursement models, utilization trends, manufacturer strategies, and emerging therapies.
- Experience leading complex cross-functional initiatives and influencing outcomes across operations, pricing, contracting, finance, clinical, product, and account management teams.
- Exceptional executive communication, presentation, relationship management, and negotiation skills.
- Solid analytical and financial acumen, with the ability to translate operational and pricing data into actionable business recommendations.
Nice To Haves
- Licensed pharmacist.
- Experience supporting large employer, health system, GPO, or national healthcare client relationships.
- Experience with specialty pharmacy pricing, financial guarantees, or performance oversight.
- Knowledge of biosimilars, gene therapies, rare disease management, and value-based specialty care models.
- Experience presenting operational performance, pricing results, and recommendations to executive leadership and client stakeholders.
- Experience working in highly matrixed organizations and managing multiple operational and strategic priorities simultaneously.
Responsibilities
- Lead operational performance and delivery of specialty pharmacy services and programs supporting HealthTrust.
- Oversee specialty pricing, financial performance, guarantees, and related contractual commitments.
- Establish governance, operating routines, and accountability across HealthTrust, Optum Specialty, and Optum Rx teams.
- Monitor service levels, operational metrics, pricing results, and client outcomes; identify risks and lead corrective actions.
- Partner with pricing, underwriting, contracting, finance, and analytics teams to evaluate specialty cost drivers and support competitive, sustainable pricing.
- Lead issue resolution and escalation management for complex specialty operational, pricing, and service matters.
- Collaborate with clinical, product, account management, and operations teams to implement and execute specialty initiatives successfully.
- Drive continuous improvement to strengthen operational efficiency, service quality, financial performance, and the HealthTrust partnership.
- Serve as the primary specialty pharmacy subject matter expert and operational advisor to HealthTrust leadership and stakeholders.
- Lead business reviews, operational planning sessions, pricing discussions, and client presentations.
- Assess specialty pharmacy trends, pipeline therapies, biosimilars, gene therapies, and regulatory developments for operational and financial impact.
- Contribute to specialty strategy and roadmap decisions by bringing forward client needs, performance insights, market intelligence, and practical recommendations.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
