Senior Network Pricing Consultant - Remote2371837 | Eden Prairie, Minnesota | Remote

PBM Network Pricing Analyst

Optum Rx is looking for a curious, adaptable, and self-motivated professional to join our Network Pricing team in a hybrid role that combines PBM network pricing expertise with transformation delivery. This role will support prescription drug pricing analysis, client performance management, and financial modeling while also contributing to process improvement, data product adoption, operating model change, and cross-functional transformation initiatives. The person in this role will build a solid understanding of PBM pricing fundamentals, claims and contract data flows, analytical tools, and the systems used to support pricing decisions.

Solid communication and stakeholder management skills are essential, as this role partners closely with Network Pricing, Data Science, Operations and technology teams to deliver measurable business outcomes.

Supports PBM network pricing, client performance management, and transformation initiatives through financial modeling, claims and contract analysis, reporting, process improvement, and cross-functional delivery. Conducts pricing and unit cost analysis in support of pharmacy network strategies, client guarantees, contract valuation, and operational decision-making. Partners with business, analytics, and technology teams to improve tools, data products, workflows, and governance practices that support scalable and accurate pricing operations.

Primary Responsibilities:

• Lead complex PBM network pricing analysis, financial modeling, scenario evaluation, and unit cost initiatives supporting pharmacy network strategy, client guarantee performance, contract valuation, and executive decision-making
• Serve as a senior subject matter expert for claims, contract, pricing, reimbursement, MAC, network, and utilization data, translating complex findings into clear recommendations and business actions
• Own or lead cross-functional work streams that improve pricing tools, data products, governance, operating model processes, reporting capabilities, and scalable business controls
• Partner with senior stakeholders across Network Pricing, Data Science, Operations, Product, Technology, Finance, and other business teams to shape priorities, define requirements, resolve issues, and deliver measurable outcomes
• Drive transformation delivery by identifying process gaps, automation opportunities, control weaknesses, and operational risks, then leading practical solutions from discovery through implementation and adoption
• Provide analytical leadership on pricing anomalies, client performance drivers, pharmacy network trends, reimbursement changes, and claims data issues, including root-cause analysis and recommended remediation
• Lead Agile delivery activities for pricing-related capabilities, including backlog refinement, prioritization, requirement definition, user acceptance testing, release readiness, stakeholder communication, and adoption tracking
• Mentor and guide less experienced team members by sharing pricing knowledge, analytical methods, business context, and best practices for stakeholder engagement and delivery execution
• Prepare executive-ready materials, decision summaries, action plans, and status updates that clearly communicate risks, trade-offs, recommendations, and progress against business priorities

Required Qualifications:

• 5+ years of analytical experience in financial analysis, health care pricing, PBM network pricing, network management, health care economics, pharmacy benefit management, or a related discipline
• 5+ years of experience developing, maintaining, or leading financial models, analytical tools, spreadsheets, dashboards, or reporting outputs used to support pricing strategy and business decisions
• 3+ years of experience leading process improvement, business transformation, operational change, product delivery, or technology-enabled initiatives
• Demonstrated experience using claims, contract, reimbursement, pricing, utilization, or network data to identify business insights, risks, and improvement opportunities
• Proven ability to lead cross-functional initiatives, manage competing priorities, influence stakeholders, and drive outcomes in a complex matrixed environment
• Proven understanding of Agile delivery practices, including requirements definition, backlog management, prioritization, testing, release planning, and adoption support
• Proven excellent executive communication skills, with the ability to summarize complex analysis, business impacts, risks, and recommendations for senior leaders
• Proven solid analytical, critical thinking, problem-solving, and decision-making skills, with the ability to operate independently in a fast-paced environment

Preferred Qualifications:

• Product Owner, Scrum Master, Project Management, Business Analysis, Lean/Six Sigma, or similar certification
• Advanced experience in PBM, pharmacy network pricing, reimbursement strategy, contract valuation, MAC pricing, client guarantees, claims analysis, or health care economics
• Experience leading…