Vice President, Payer Relationships
About The Position
The Vice President of Payer Relationships provides executive leadership for Optum Pharmacy’s national payer engagement, contracting, and market access strategy across Specialty Pharmacy, Infusion Pharmacy, Home Delivery, and future growth platforms. The role leads Senior Directors responsible for regional and national payer relationships and develops enterprise contracting strategies to support profitable growth, patient access, strategic partnerships, and long-term business objectives. The Vice President owns executive relationships with key national payer organizations and industry stakeholders, leads complex negotiations and innovative value-based arrangements, and collaborates with executives across contracting, operations, clinical services, finance, product, government affairs, growth, and strategy. The position oversees payer strategy, medical benefit contracting, market access, financial performance, and cross-functional implementation of payer agreements. It also requires current knowledge of reimbursement, payer economics, regulations, and market trends, and representing Optum Pharmacy with external stakeholders and strategic partners. The role can be performed remotely from anywhere within the United States. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.
Requirements
- 10 or more years of experience in healthcare payer contracting, market access, managed care, or healthcare strategy.
- 5 or more years of progressive leadership experience managing senior leaders and large-scale payer organizations.
- Extensive experience negotiating complex pharmacy and medical benefit agreements.
- Deep understanding of Commercial, Medicare, Medicaid, and Government reimbursement models.
- Proven record of delivering significant revenue growth, covered-lives expansion, and value creation.
- Demonstrated success leading large, matrixed organizations and enterprise-wide initiatives.
- Strong executive presence and exceptional influencing, negotiation, communication, and relationship-building skills.
- Ability to lead in complex and rapidly evolving healthcare environments.
Nice To Haves
- Specialty pharmacy, infusion pharmacy, or PBM leadership experience.
- Experience developing and implementing value-based care and risk-sharing models.
- MBA, MHA, PharmD, or another advanced healthcare or business degree.
- Experience managing national payer portfolios representing significant enterprise revenue.
Responsibilities
- Develop and execute enterprise payer relationship and contracting strategy across pharmacy business segments.
- Lead and mentor Senior Directors responsible for regional and national payer partnerships.
- Establish multi-year plans to drive access, growth, profitability, and competitive differentiation.
- Sponsor strategic payer initiatives and transformational contracting models.
- Build and maintain executive relationships with health plans, integrated delivery systems, employers, government programs, and emerging healthcare organizations.
- Represent Optum Pharmacy in industry forums, conferences, and executive payer engagements.
- Identify opportunities to expand market share, improve access, and strengthen payer partnerships.
- Oversee medical benefit contracting across Commercial, Medicare, Medicaid, Exchange, and Government programs.
- Lead negotiations for high-value agreements and enterprise-wide payer relationships.
- Develop innovative contracting approaches, including value-based care, shared savings, quality incentives, site-of-care optimization, and risk-sharing agreements.
- Ensure consistent contracting philosophies, governance, and financial performance across payer engagements.
- Manage enterprise payer access, covered-lives growth, revenue expansion, and profitability targets.
- Partner with finance, actuarial, and pricing leaders to evaluate opportunities and optimize contract economics.
- Oversee business cases for strategic investments, expansion opportunities, and new market initiatives.
- Monitor payer portfolio performance and allocate resources using data-driven decision making.
- Align payer strategies with enterprise growth initiatives, regulatory requirements, and customer needs.
- Lead cross-functional teams to implement and operationalize payer agreements.
- Maintain knowledge of healthcare reimbursement, payer economics, CMS regulations, state regulatory requirements, and market trends.
- Anticipate competitive, regulatory, and market changes and develop proactive strategies.
- Identify opportunities in specialty pharmacy, infusion services, home-based care, behavioral health, and value-based care.
- Represent Optum Pharmacy as a thought leader with external stakeholders and strategic partners.
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401(k) contribution
- Career development opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Executive
Education Level
No Education Listed
