Associate Director Industry Relations - Telecommute
Irvine, CA, United States
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
OptumCare is a nearly $30 billion a year organization, touching over 17 million patients, 90 payers and >50,000 aligned physicians. As part of Clinical Transformation, RxCare Solutions is a portfolio of capabilities and assets to accelerate growth by driving clinical value and outcomes that is grounded in evidence. The role is responsible for advancing and strengthening our strategic partnerships with pharmaceutical companies to critically evaluate clinical outcomes and economic impacts with real world evidence to inform patient-centric and value-conscious treatment decisions, across the continuum of care agnostic of pharmacy or medical benefits.
Our goal is to deliver high-quality, integrated services to promote optimal outcomes, economic savings, and outstanding provider and consumer experiences.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Build and execute agreements with pharmaceutical companies aimed at improving clinical outcomes that are measured and tracked through professional, outpatient, and inpatient claims and clinical databases
Strategize, develop, and recommend innovative solutions to promote clinically appropriate treatment choices that also drive economic value to the patient, provider, and care delivery organizations
Collaborate with a cross functional internal teams (e.g. Rebates, UW, Pricing, HCE, Actuarial, and Clinical) to identify areas of opportunities for risk bearing entities, TPAs, IPAs, and medical groups across different lines of business
Design and create medical rebate assumptions and forecast models, in partnership with others to resolve business problems that affect multiple functional areas, including audit data for accuracy and troubleshoot variances in modeling
Understand, build, and maintain financial models, analytics, and reports for (medical) rebate guarantee optimization, value-focused arrangements, and positive/negative impact to clinical outcomes (such as down-side risk for poor outcomes)
Create net-cost-to-payer (or RBE) financial models for specific therapeutic classes, market basket, and disease grouping/condition scenarios (based on ICD10 codes, or other groups)
Deep knowledge of medical groups, IPAs, medical claims and informatics, economic forecast modeling to achieve performance goals
Communicate results of process development, financial impact, and analyses to appropriate stakeholder groups (e.g. Affordability, Pricing, Accrual, Accounting, Forecasting, Underwriting, Rebate Billing, Data Operations, Legal, and other internal customers)
Create best practices to maximize efficiency, enhance data repositories (for data transfers and audits), and streamline process workflows with compressed and varying timelines
Leverage pharmaceutical, business, and regulatory knowledge to ensure proposed solutions and/or strategic partnerships are in compliance with all state and federal regulations
Develop comprehensive value assessment methods, to evaluate economic, clinical, and humanistic outcomes of pharmaco-interventions to accelerate identification of opportunities, quantify value, and measure actual value achieved
Identify and implement solutions to support market access and reimbursement of pharmacotherapy products across different payment models, including FFS, capitation, shared-risk, global risk, etc.
Any other duties that may be required by the department
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.
5+ years of experience in managed health care or pharmacy benefit management, with a focus on pharmaceutical contracting negotiations and strategy development
5+ years of experience with financial analyses and economic models across medical and pharmacy claims, clinical data, and benchmarks
5+ years of experience with pharmaceutical rebate designs, arrangements, and contract executions
5+ years of advanced Excel (pivots and macros) and database skills
5+ years of extensive knowledge of CMS Part A, B, C, and D benefits and requirements
Solid interpersonal skills, able to quickly establish rapport and work well with others to define and achieved shared business growth and affordability goals
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex financial, clinical, and technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Solid attention to detail, customer service skills; demonstrated customer centricity; understands the customer, makes customer-centric decisions, and adapts to changing customer information
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado/Connecticut/Nevada residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Doctorate of Pharmacy, Associate Director, Industry Relations, Director, RxCare Solutions, Manager Pharmacy Solutions, Pharmaceutical, Pharmacy, Medical, Benefits, Care Delivery, Rebate, Data, Clinical Outcomes, Results, Financial Models, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote