Associate Director, Network Contracting

About Optum and the Role

Optum, a global healthcare organization, leverages technology to enhance the lives of millions by connecting individuals to essential care, pharmacy benefits, and health data. This role offers an impactful opportunity to improve health equity globally while working from Dublin, Ireland, supporting the US healthcare market with a hybrid work model combining office and remote work.

Primary Responsibilities

• Lead the execution of pharmacy network contracting strategies across commercial, Medicare, and Medicaid sectors.
• Optimize network makeup, reimbursement frameworks, and provider engagement to balance cost efficiency, accessibility, and quality.
• Assess network adequacy, geographic coverage, and potential disruptions to guide strategic planning.
• Support initiatives for network expansion, performance advancement, and disruption management.
• Conduct complex contract negotiations with national chains, regional pharmacies, provider services administrative organizations (PSAOs), and independent providers.
• Develop agreements covering ingredient cost reimbursements using multiple pricing constructs, dispensing fees, performance-based reimbursements, network participation terms, audit clauses, and termination conditions.
• Ensure contracts reduce financial, operational, and reputational risks and manage contract life cycles including renewals and amendments.
• Drive improvements in pharmacy unit cost via rates and innovative reimbursement mechanisms.
• Collaborate with finance and actuarial teams for financial modeling and contract economic validation.
• Track financial performance against targets including ingredient cost trends and total care costs.
• Identify opportunities to improve margins while preserving competitive access.
• Ensure strict compliance with federal and state regulations such as CMS Medicare Part D, Medicaid managed care rules, and state-specific mandates (e.g., AWP laws, NADAC).
• Work alongside legal and compliance teams to adapt contracting strategies to regulatory changes and respond to audits and inquiries.
• Collaborate cross-functionally with clinical, operations, legal, compliance, finance, and product teams to align contracting with overall business objectives.
• Translate client and market requirements into practical contracting strategies and support sales efforts including RFP responses.
• Monitor the pharmacy market landscape, including consolidation trends, specialty pharmacy evolution, and vertical integrations.
• Benchmark against competitor reimbursement and contracting strategies and deliver insights on key partners such as CVS, Walgreens, Walmart, and others.
• Lead and develop a team of contracting professionals, setting clear performance goals and promoting robust contracting standards.
• Engage with clients at executive levels to discuss network performance, risk mitigation, and cost issues, supporting client retention and strategic initiatives.

Requirements

• Bachelor’s degree in Business, Finance, Healthcare Administration, or a related field.
• Extensive experience in pharmacy contracting, pharmacy benefits management (PBM), healthcare payer environments, or related fields.
• Demonstrated leadership experience, including managing and developing teams.
• Proven track record negotiating complex provider or vendor contracts.
• Strong financial skills with the ability to analyze pricing models and cost drivers.

Preferred Qualifications

• Advanced degrees such as MBA, MHA, or PharmD.
• In-depth knowledge of PBM reimbursement methods, including AWP, NADAC, MAC, and specialty pricing.
• Experience with Medicare Part D, Medicaid managed care, and commercial regulatory frameworks.
• Familiarity with major pharmacy chains and independent pharmacy networks.
• Experience supporting RFPs and client-facing strategic discussions.

Additional Information

Applicants must have unrestricted eligibility to work and reside in the relevant country. UnitedHealth Group values diversity and inclusion and is committed to providing equitable healthcare. Optum is an Equal Employment Opportunity employer and a drug-free workplace.