Director of Specialty Pharmacy Payor Services - Remote

CPS Solutions, part of the Optum family of business, is seeking a full-time, exempt Director of Specialty Pharmacy Payor Services to join our specialty pharmacy team. This position leads the development and successful implementation of pharmacy services to ensure a client's payor contracting, benefits design and services and revenue cycle management for pharmacy services, build strong collaborative relationships with other key leaders and professionals within CPS, client leaders and other key stakeholders in the organization.
Schedule: This position works at least 40 hours per week, primarily Monday - Friday and requires travel away from a home location for varying lengths of time up to 60%.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Facilitate and assist in the development of client-specific specialty and ambulatory pharmacy payor implementation plans. This includes:
  • Project management
  • Assisting in financial assessments
  • Review of benefits and services
  • Pharmacy and ERx data review
  • Revenue cycle management review and value
  • Managing requests and purchases
• Assist in the development and successful execution of integrated strategies for the delivery of payor strategies and other key initiatives to achieve high quality affordable care and improve the health of those served
• Facilitating payor credentialing, claims reconciliation and request for proposal for clients
• Support a high-level of collaboration between client's pharmacy, medical contracting and benefits teams, and executive leadership to leverage organizational, pharmaceutical and medical expertise to develop and maximize payor programs, strategy and access
• Execute upon goals, strategies and tactics to ensure ongoing client success, this includes; helping clients grow their pharmacy programs and ensuring that their program achieves profitable growth
• Identify opportunities and issues that impact client services and performance by engaging key stakeholders to plan, develop, and successfully execute timely and appropriate initiatives and solutions that result in appropriate performance improvement
• Establish systems to manage external relationships with third-party payors on behalf of CPS clients, including overseeing compliance and credentialing of programs and specialty pharmacy network contract

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:

• Management/supervisory experience
• Experience managing pharmacy payors contracting and implementing benefits design
• Able to travel approximately 60% of the time away from home location
• Ability to meet company standards for a Motor Vehicle Report (MVR) background check

Preferred Qualifications:

• Demonstrated experience collaborating with diverse stakeholders enhancing business results through high quality and cost-effective specialty pharmacy services, executing complex projects preferably in a hospital setting
• Demonstrated building effective relationships with key stakeholders, and optimization strategies is preferred

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.