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Optum

Associate Director, Network Contracting

Posted 2 Hours Ago
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Hybrid
Dublin, IRL
Senior level
Hybrid
Dublin, IRL
Senior level
Lead pharmacy network contracting strategy across commercial, Medicare, and Medicaid lines. Negotiate complex agreements with chains, PS AOs, and independents; optimize network composition and reimbursement models; partner with finance, legal, and clinical teams to manage contract lifecycle, compliance, cost performance, and client engagements; lead and develop a contracting team while providing market intelligence and supporting RFPs and client strategies.
The summary above was generated by AI
Requisition Number: 2365950
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 diversity and inclusion, 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 and self-motivated individual to identify and develop strategies that leverage the full breadth of Optum assets to solve healthcare's biggest challenges in the area of pharmacy services. This role will be responsible for understanding the needs of industry partners and developing business solutions using the data and capabilities of Optum. We are looking for people that can collaborate with business partners, anticipate future industry needs, and have solid financial acumen. This is a unique opportunity to work in the US Healthcare market from Ireland.
Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin office and telecommuting from a home-based office in a hybrid work model.
Primary Responsibilities:
Network Strategy & Optimization
  • Lead execution of pharmacy network contracting strategy across commercial, Medicare, and Medicaid lines of business
  • Optimize network composition, reimbursement structures, and provider participation to balance cost, access, and quality outcomes
  • Evaluate network adequacy, disruption risk, and geographic coverage to inform strategic decisions
  • Support network expansion, performance improvement initiatives, and disruption mitigation planning

Contract Negotiation & Execution
  • Lead complex negotiations with national chains, regional pharmacies, PSAOs, and independent providers
  • Structure agreements inclusive of: Ingredient cost reimbursement (AWP, NADAC, WAC-based constructs), dispensing fees and performance-based reimbursement models & network participation terms, audit provisions, and termination language
  • Ensure contract terms mitigate financial, operational, and reputational risk
  • Oversee contract lifecycle management, including renewals, amendments, and strategic terminations

Financial Performance & Cost Management
  • Drive pharmacy unit cost improvements through rate optimization and innovative reimbursement strategies
  • Partner with finance and actuarial teams to model and validate contract economics
  • Monitor financial performance against targets, including ingredient cost trends and total cost of care impact
  • Identify and execute margin enhancement opportunities while maintaining competitive access

Regulatory Compliance & Risk Management
  • Ensure network contracts and strategies comply with all applicable federal and state regulations, including: CMS Medicare Part D requirements, Medicaid managed care regulations (e.g., network adequacy, reimbursement floors) & State-specific commercial and exchange mandates (e.g., AWP laws, NADAC requirements, Any Willing Provider)
  • Partner with legal and compliance teams to incorporate regulatory changes into contracting practices
  • Support audits, regulatory inquiries, and client reporting obligations

Cross-Functional Leadership
  • Collaborate with clinical, operations, legal, compliance, finance, and product teams to align contracting strategy with enterprise objectives
  • Translate client requirements and market dynamics into actionable contracting strategies
  • Support RFP responses, sales initiatives, and client retention efforts through network strategy articulation
  • Ensure seamless operationalization of contract terms

Market Intelligence & Competitive Insights
  • Monitor pharmacy industry dynamics, including: Chain consolidation and store closures, specialty pharmacy channel evolution & manufacturer and pharmacy vertical integration
  • Benchmark reimbursement and contracting strategies against competitors
  • Develop actionable insights on key partners (e.g., CVS, Walgreens, Walmart, Kroger, independents)

Team Leadership & Development
  • Lead, coach, and develop a team of contracting professionals
  • Establish performance expectations and build negotiation and financial acumen across the team
  • Promote disciplined contracting practices, governance, and documentation standards
  • Foster a collaborative, results-oriented culture

Client & Stakeholder Engagement
  • Support client interactions related to pharmacy networks, including performance reviews and issue resolution
  • Provide executive-level insights on network performance, disruption risk, and cost trends
  • Partner with account teams to address client-specific network needs and strategic initiatives

You will 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 providing development for other roles you may be interested in.
Required Qualifications:
  • Bachelor's degree in Business, Finance, Healthcare Administration, or a related field
  • Proven extensive experience in pharmacy contracting, PBM, healthcare payer, or a related field
  • Proven solid experience in a leadership or people management capacity
  • Proven experience negotiating complex provider or vendor agreements
  • Demonstrated solid financial acumen, with the ability to interpret pricing models and cost drivers

Preferred Qualifications:
  • MBA, MHA, PharmD, or other advanced degree
  • Demonstrated deep knowledge of PBM reimbursement methodologies, including AWP, NADAC, MAC, and specialty pricing models
  • Proven experience working with Medicare Part D, Medicaid managed care, and commercial regulatory environments
  • Demonstrated familiarity with major pharmacy chains and independent network structures
  • Proven experience supporting RFPs and client facing strategy discussions

Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.
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.
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2026 Optum Services (Ireland) Limited. All rights reserved.
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Optum Dublin, Dublin, IRL Office

Optum Dublin, Ireland Office

Dublin, Ireland

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