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.
About the Role:
The Senior Director, Network Pricing Strategy is a strategic leader within OptumRx's Network team, responsible for delivering network margin performance, regulatory alignment and related strategies across all lines of business, clients & pharmacies.
You will lead a team of business and data analysts and be responsible for setting the direction for network pricing to navigate the quickly changing regulatory landscape and defining pricing strategies to transform the network pricing model. You will also evolve how network value is currently analyzed, optimized and delivered. Success in this role depends on deep collaboration with Finance, Legal, Underwriting and Network colleagues, ensuring strategies are aligned, risks are managed, and opportunities are captured in an efficient and timely manner.
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 or Letterkenny office and telecommuting from a home-based office in a hybrid work model.
Key Responsibilities:
Network Strategic Leadership & Innovation
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Partner closely with regulatory, legal and other network teams to define and document business interpretations of state regulations and capture key stakeholder feedback on the same
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Develop pricing strategies which navigate these regulations, mitigate financial impacts and present proposals to executives to gain leadership alignment. Partner with provider and client contracting/ underwriting teams to ensure contracting is aligned. Support and oversee implementations accordingly and work with finance partners to appropriately forecasts for impacts
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Develop pricing strategies and provide strategic and analytical support for transformation initiatives across all lines of business (Commercial, Medicare, Medicaid)
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Develop pricing strategies to drive incremental network value to support gap fill
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Leverage of-the-day capabilities to better understand & derive opportunities from our existing client agreements; design and evaluate novel client contracting approaches, motivated by findings of same
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Lead the development and execution of network strategies using AI-powered analytics, automation, and innovative models
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Work with Underwriting to appropriately account for state regulations and integrate desired network strategies into pricing and risk models
Network Margin Gap Fill & Reporting
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Responsibility for guiding the delivery of network margin stretch targets, driving accountability with network teams
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Partner closely with Finance to align network performance with our overarching financial objectives
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Cross-reference client and pharmacy performance data to inform strategic decisions
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Lead our Retail Gap Fill agenda - initiative pipeline, risk mitigation, alignment on progress & communication of same
Network Analytics
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Analyze the impact of state and federal regulations specific to Network, communicating risks & viable paths forward which minimize risk to the enterprise
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Collaborate with Legal, Operations and Underwriting to represent, implement & maintain compliant, strategic pricing frameworks which align to regulatory demands
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Support with network queries from Market Conduct Exams and other regulatory audits
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Develop a network margin intelligence suite enabling validation, providing real time analysis of key network margin drives and enabling validation of all budget and forecast assumptions
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Analyze utilization and mix impacts on network performance, both prior & future
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Develop trend reporting on key market benchmarks e.g. PAC, NADAC, WAC, AWP
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Support ad hoc analyses with scalable, intelligent analytics platforms
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Support operations teams with providing strategic direction on implementations
Client Contract Management
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Client accrual and performance reporting and forecasts
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Client over and under performance forecasts for forecast cycles
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Collate contractual blockers on key clients and report on related financial impacts, partnering with Underwriting to proactively tackle these items on a medium-term basis
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Implement robust process for client margin prioritization, integrating to pricing tools WFM
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Collate and prioritize all pricing tool requirements from CCM team and work with product managers to enhance the tools roadmap with a supporting capital backlog
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Responsibility for UHC E&I and M&R reporting, analytics and pricing activities
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Leverage AI and automation to review client contracts at scale to identify incremental margin opportunities
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:
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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