Strategic Medical Contract Leader - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This role will be responsible for expanding medical payer access for Optum Specialty Pharmacy (OSP) through the development, negotiation, implementation, and management of medical benefit contracts. The position will support strategic growth initiatives by identifying access gaps, prioritizing payer opportunities, and driving execution of contracting strategies that increase covered lives, improve market access, and support revenue growth.

You'll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

• Lead efforts to expand OSP participation with targeted medical payers and health plans
• Identify and prioritize contracting opportunities using medical access analytics, OON reporting, market intelligence, and revenue opportunity assessments
• Develop and execute contracting strategies designed to increase patient access and improve reimbursement economics
• Lead negotiations, contract implementation activities, and ongoing payer relationship management for medical benefit agreements
• Collaborate with Finance, Operations, Account Management, Network Management, Legal, and Compliance to support medical contracting initiatives
• Monitor contract performance and identify opportunities for optimization, expansion, and enhanced payer partnerships
• Support achievement of enterprise growth objectives through increased medical payer access and diversification of the payer portfolio
• Maintain awareness of evolving market trends, alternative access models, and competitive dynamics impacting specialty pharmacy access

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• 3+ years of experience in managed care, healthcare payer contracting, provider network management, specialty pharmacy, PBM, infusion, or related healthcare field
• Experience negotiating and managing payer, provider, or healthcare-related contractual agreements
• Experience working with health plans, PBMs, employers, TPAs, provider organizations, or integrated delivery systems
• Knowledge of medical and pharmacy benefit structures, reimbursement methodologies, and network access strategies
• Demonstrated ability to build and maintain relationships with internal and external stakeholders

• Proficiency with Microsoft Office applications, including Excel and Power Point
• Demonstrated ability to manage multiple priorities in a fast-paced environment
• Demonstrated solid analytical and problem-solving skills with the ability to evaluate business opportunities and financial impact
• Demonstrated solid written and verbal communication skills, including presentation and negotiation capabilities

• The ideal candidate will bring a blend of:
  • Managed care expertise
  • Medical contracting and network development experience
  • Specialty pharmacy or pharmacy care services knowledge
  • Strategic relationship management
  • Consultative sales and negotiation skills
  • Analytical decision-making capability
  • Ability to…