Senior Manager, Pharmacy Value Capabilities & Decision Support - Remote

UnitedHealth Group•Draper, UT

2d•$112,700 - $193,200•Remote

About The Position

The Senior Manager, Pharmacy Value Capabilities & Decision Support serves as the business owner for technology-enabled and AI-enabled capabilities supporting value product selection, clinical decision support, and pharmacy affordability across Optum Health. The role translates clinical, financial, payer, and operational priorities into scalable tools intended to improve affordability, provider experience, patient access, workflow automation, and value realization. The position leads the roadmap, implementation, lifecycle management, and adoption of enterprise pharmacy value tools, including the Pharmacy Value Product Navigator and related decision-support capabilities embedded within Epic, utilization management, and operational platforms. It works across Pharmacy, Healthcare Economics, Finance, Technology, Utilization Management, Market Leadership, Operations, and vendor partners, as well as clinical and analytics teams. The role is remote within the United States. Hires in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.

Requirements

At least 5 years of experience in healthcare, managed care, a health plan, PBM, provider, value-based care, healthcare technology, or a related healthcare environment.
Experience in product management, capability management, or program management.
Experience improving healthcare workflows through technology-enabled solutions.
Experience translating business, operational, clinical, or technology needs into business requirements, process maps, user stories, acceptance criteria, workflows, and implementation plans.
Experience working with large healthcare datasets, claims, utilization, reimbursement, or financial data, and ability to interpret data models, reporting structures, KPIs, and analytical outputs.
Experience partnering with analytics, data engineering, or business intelligence teams to translate business needs into scalable reporting and decision-support solutions.
Experience leading complex cross-functional initiatives across matrixed teams.
Experience developing executive presentations, strategic recommendations, or business cases.
Demonstrated ability to influence without direct authority.

Nice To Haves

PharmD or pharmacist licensure.
Experience with pharmacy benefit or medical benefit drug management.
Experience with utilization management workflows or platforms.
Experience with clinical informatics, Epic, or electronic medical record-enabled decision-support workflows.
Experience with product or capability development for clinical decision-support tools.
Knowledge of rebate economics, manufacturer programs, or preferred product strategy.
Experience evaluating, implementing, or governing AI-enabled solutions, automation tools, generative AI tools, or digital transformation initiatives to improve analysis, workflow efficiency, content generation, or decision support.
Experience with Power BI, Tableau, or other business intelligence visualization platforms.
Knowledge of SQL or other data query tools, including ability to validate logic, understand joins, review outputs, and partner effectively with analytics teams.
Experience supporting pharmacy affordability, value-based care, or total cost of care initiatives.

Responsibilities

Own the strategic vision, roadmap, and business requirements for pharmacy value and decision-support capabilities, including the Pharmacy Value Product Navigator and related affordability solutions.
Translate preferred product strategies, rebate opportunities, payer requirements, clinical policies, and operational priorities into scalable product direction.
Establish governance processes for intake, prioritization, enhancement evaluation, lifecycle management, and stakeholder decision-making.
Identify and prioritize technology, analytics, and AI-enabled opportunities to improve affordability, scalability, workflow automation, adoption, and value realization.
Integrate clinical, operational, financial, and payer intelligence into actionable decision-support frameworks.
Operationalize clinically approved preferred-product and affordability strategies into scalable decision-support workflows.
Partner with clinical leadership, sourcing and procurement, market teams, and operational stakeholders to translate approved direction into practical tool design.
Serve as business lead for pharmacy value and decision-support capabilities, aligning cross-functional teams and vendor partners.
Facilitate stakeholder alignment on priorities, decision rights, solution design, deployment, change management, outcome measurement, and investment needs.
Develop executive-ready recommendations, business cases, and performance updates for prioritization, technology investment planning, and leadership decisions.
Partner with technology, analytics, product, clinical informatics, AI engineering, and clinical stakeholders to define solution scope, development priorities, governance needs, and implementation plans.
Guide development of decision-support tools embedded in provider, payer, and utilization management workflows.
Evaluate, implement, and govern AI-enabled decision-support capabilities, automation tools, and digital transformation initiatives, including documentation, validation, and required AI review approvals.
Develop business requirements, process maps, user stories, acceptance criteria, workflow documentation, adoption metrics, technology investment needs, resourcing implications, and development dependencies.
Lead testing, implementation readiness, change management, enhancement planning, and development pipeline prioritization consistent with Capability Management practices.
Establish KPIs and performance measurement frameworks for pharmacy value initiatives, provider adoption, operational performance, and value realization.
Quantify financial impact and affordability opportunities related to preferred product optimization, rebate strategies, and medical versus pharmacy benefit pathways.
Support forecasting, opportunity sizing, strategic prioritization, and business case development through analytics and insight generation.
Develop performance updates and value reporting to inform leadership decisions and ongoing capability enhancement.