Perform PBM network pricing and financial modeling to support pricing strategy, contract valuation, client guarantees, and operational decisions. Analyze claims, pricing, contract, and utilization data to produce insights and executive-ready recommendations. Partner with analytics, operations, and technology teams to improve pricing tools, data products, workflows, and governance. Support Agile delivery, prioritize requirements, test enhancements, identify risks and anomalies, and drive adoption of process improvements and automation to scale pricing operations.
Requisition Number: 2371836
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 talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
OptumRx 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:
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.
Required Qualifications:
Preferred Qualifications:
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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 talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
OptumRx 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 and perform financial analysis and modeling related to prescription drug pricing, pharmacy network performance, client guarantees, and unit cost management
- Conduct PBM network pricing analysis, reporting, and scenario modeling to support pricing strategy, contract valuation, and operational decision-making
- Translate complex claims, pricing, contract, and utilization data into clear insights, recommendations, and executive-ready summaries
- Partner with business, analytics, operations, and technology teams to deliver transformation initiatives that improve pricing tools, data products, workflows, and governance
- Support Agile delivery by helping define requirements, prioritize work, test enhancements, track risks, and drive adoption of new capabilities across pricing and related business teams
- Proactively identify anomalies, risks, and improvement opportunities across drug pricing, client performance, utilization patterns, contract logic, and prescription claims data
- Participate in the development of new pricing approaches, analytical products, automation opportunities, and process improvements that strengthen business controls and scalability
- Collaborate independently with subject matter experts and stakeholders across Network Pricing, Data Science, Operations and technology teams
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.
Required Qualifications:
- 2+ years of analytical experience in financial analysis, health care pricing, PBM network pricing, network management, health care economics, or related discipline
- 2+ years of experience developing, maintaining, or using financial models, analytical tools, spreadsheets, or reporting outputs to support pricing decisions and actionable business recommendations
- 2+ years of experience supporting process improvement, business transformation, operational change, or technology-enabled initiatives
- Proven experience working in an Agile environment and solid understanding of Agile methodologies and principles
- Proven excellent collaboration, communication, and stakeholder management skills, with the ability to work across business, analytics, operations, and technology teams
- Ability to prioritize and manage multiple tasks, deadlines, and stakeholder needs effectively
- Proven solid analytical, critical thinking, and problem-solving skills
- Ability to work in a fast-paced and dynamic environment
Preferred Qualifications:
- Certified Business Analyst, Project Manager, Product Owner, Scrum Master, or similar qualifications
- Experience in PBM, pharmacy network pricing, reimbursement, claims analysis, contract valuation, MAC pricing, or healthcare economics
- Experience translating complex analytical outputs into clear recommendations for business stakeholders
- Experience improving business workflows, user adoption, or analytical tools used by operational teams
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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