Senior Manager, Pharmacy Value Capabilities & Decision Support - Remote

Senior Manager, Pharmacy Value Capabilities & Decision Support

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.

The Senior Manager, Pharmacy Value Capabilities & Decision Support will serve as the business owner for technology-enabled and AI-enabled capabilities that support value product selection, clinical decision support, and pharmacy affordability across Optum Health. This role translates clinical, financial, payer, and operational priorities into scalable tools that improve affordability, provider experience, patient access, workflow automation, and value realization.

The position leads the roadmap, implementation, lifecycle management, and adoption of enterprise pharmacy value tools, including the Pharmacy Value Product Navigator and related decision-support capabilities embedded within Epic, utilization management, and operational platforms.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

Product Strategy & Ownership

• Own the strategic vision, roadmap, and business requirements for pharmacy value and decision-support capabilities, including the Pharmacy Value Product Navigator and related affordability solutions
• Translate preferred product strategies, rebate opportunities, payer requirements, clinical policies, and operational priorities into scalable product direction
• Governance processes for intake, prioritization, enhancement evaluation, lifecycle management, and stakeholder decision-making
• Identify and prioritize opportunities to use technology, analytics, and AI-enabled solutions to improve affordability, scalability, workflow automation, adoption, and value realization

Clinical & Business Decision Support

• Integrate clinical, operational, financial, and payer intelligence into actionable decision-support frameworks
• Operationalize clinically approved preferred product and affordability strategies into scalable decision-support workflows
• Partner with clinical leadership, sourcing/procurement, market teams, and operational stakeholders to translate approved direction into practical tool design

Cross-Functional Leadership

• Serve as the business lead for pharmacy value and decision-support capabilities, aligning Pharmacy, Healthcare Economics, Finance, Technology, Utilization Management, Market Leadership, Operations, and vendor partners
• Facilitate stakeholder alignment on priorities, decision rights, solution design, deployment approach, change management, outcome measurement, and investment needs
• Develop executive-ready recommendations, business cases, and performance updates to support prioritization, technology investment planning, and leadership decision-making

Technology & Capability Development

• Partner with technology, analytics, product, clinical informatics, AI engineering, and clinical stakeholders to define solution scope, development priorities, governance needs, and implementation plans
• Guide development of decision-support tools embedded within provider, payer, and utilization management workflows
• Partner with AI engineering, technology, analytics, data engineering, clinical informatics, and clinical stakeholders to evaluate, implement, and govern AI-enabled decision-support capabilities, automation tools, and digital transformation initiatives, including documentation, validation, and required approval through AI review processes
• Develop business requirements, process maps, user stories, acceptance criteria, workflow documentation, adoption metrics, technology investment needs, resourcing implications, and development dependencies
• Lead testing, implementation readiness, change management, enhancement planning, and development pipeline prioritization consistent with Capability Management practices

Analytics, Performance & Value Measurement

• Establish KPIs and performance measurement frameworks to evaluate pharmacy value initiatives, provider adoption, operational performance, and value realization
• Quantify financial impact and affordability opportunities related to preferred product optimization, rebate strategies, and medical vs. pharmacy benefit pathway considerations
• Support forecasting, opportunity sizing, strategic prioritization, and business case development through actionable analytics and insight generation
• Develop performance updates and value reporting to inform leadership decisions and ongoing capability enhancement

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:

• 5+ years of experience in a healthcare, managed care, health plan, PBM, provider, value-based care, healthcare technology, or related healthcare environment
• Experience in product management, capability management, or program management
• Experience improving healthcare workflows through technology-enabled solutions
• Experience translating business, operational, clinical, or technology needs into business requirements, process maps, user stories, acceptance criteria, workflows, and implementation plans.
• Experience working with large healthcare datasets, claims, utilization, reimbursement, or financial data; ability to interpret data models, reporting structures, KPIs, and analytical outputs.
• Experience partnering with analytics, data engineering, or business intelligence teams to translate business needs into scalable reporting and decision-support solutions
• Experience leading complex cross-functional initiatives across matrixed teams
• Experience developing executive presentations, strategic recommendations, or business cases
• Demonstrated ability to influence without direct authority

Preferred Qualifications:

• PharmD or pharmacist licensure
• Experience with pharmacy benefit or medical benefit drug management
• Experience with utilization management workflows or platforms
• Experience with clinical informatics, Epic, or electronic medical record-enabled decision-support workflows
• Experience with product or capability development for clinical decision-support tools
• Demonstrates knowledge of rebate economics, manufacturer programs, or preferred product strategy
• Experience evaluating, implementing, or governing AI-enabled solutions, automation tools, generative AI tools, or digital transformation initiatives to improve analysis, workflow efficiency, content generation, or decision support
• Experience with Power BI, Tableau, or other business intelligence visualization platforms
• Demonstrates knowledge of SQL or other data query tools, including ability to validate logic, understand joins, review outputs, and partner effectively with analytics teams
• Experience supporting pharmacy affordability, value-based care, or total cost of care initiatives

*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 - $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.