Sr. Pharmacy Advisor - Remote

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Senior Pharmacy Advisor, Drug Trend & Affordability Performance is an individual contributor responsible for providing the Chief Pharmacy Officer and Government Programs Pharmacy leadership with an integrated view of Medicare Part B and Part D drug trend, financial performance, affordability results, and emerging opportunities across a significant Government Programs pharmacy spend portfolio.

The Senior Pharmacy Advisor connects clinical, utilization, financial, and operational information to explain what is driving pharmacy spend and trend, how actual results compare with expectations, whether affordability strategies are delivering intended results, and where additional action or opportunity may exist.

The role serves as the business owner for Government Programs Clinical Pharmacy reporting and analytics requirements related to Part B and Part D drug trend and affordability performance. The Senior Pharmacy Advisor works across Finance, Actuarial, Healthcare Economics (HCE), Analytics, Strategy, Industry Relations, Clinical Pharmacy, Operations, and Optum Rx to translate pharmacy performance information into actionable business insights.

The Senior Pharmacy Advisor serves as an internal subject matter expert in drug trend and affordability performance, developing informed perspectives on emerging drug-trend, affordability, and pharmacy market issues; benchmarking relevant industry practices; and identifying opportunities to improve how Government Programs Pharmacy measures, manages, and responds to drug trend and affordability.

The role also serves as a senior problem-solving resource to the CPO, supporting priority analyses and cross-functional business issues requiring pharmacy expertise, solid business judgment, and coordination across multiple organizations.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.  

Primary Responsibilities: 

Manage Part B & Part D Drug Trend Intelligence

• Maintain the integrated view of Medicare Part B and Part D drug trend and performance for Government Programs Pharmacy
• Identify and quantify the drugs, therapeutic classes, utilization patterns, unit-cost changes, mix shifts, and other factors driving performance
• Explain performance across existing therapies, new drug launches, new indications, biosimilars, generics, specialty therapies, and other material market changes
• Identify emerging trend risks, opportunities, and market shifts that warrant deeper analysis or leadership attention
• Incorporate relevant pipeline, market, regulatory, competitor, and supply developments when they materially affect the Part B or Part D financial outlook
• Develop informed perspectives on emerging drug-trend and affordability issues and their implications for Government Programs Pharmacy
• Benchmark relevant industry practices and identify opportunities to strengthen UHC's drug-trend and affordability management
• Serve as an internal subject matter expert for Part B and Part D drug trend and affordability performance and provide expertise to the CPO, Pharmacy leadership, and business partners
• Translate complex clinical, utilization, and financial information into a clear leadership narrative: what is changing, why it is changing, what it means financially, and where attention or action may be needed
• Develop and coordinate the recurring CPO Drug Trend & Affordability review, including the performance narrative, key insights, risks, decisions, and follow-up actions
   

Lead Forecast-to-Actual & Affordability Performance Management

• Establish and manage the process for comparing actual Part B and Part D drug performance with forecast, budget, and expected trend
• Partner with Finance, Actuarial, HCE, and Analytics to quantify material variances, determine underlying drivers, and assess implications for the forward outlook
• Distinguish short-term fluctuations from structural changes that could materially affect financial performance
• Maintain consolidated visibility into Pharmacy affordability initiatives, including expected value, implementation status, realized performance, and value at risk
• Determine whether material trend drivers and forecast variances are being addressed through existing affordability strategies and identify where additional evaluation may be needed
• Partner with Strategy, Clinical Pharmacy, Operations, Finance, Industry Relations, and other accountable owners to understand performance gaps and establish appropriate follow-up
• Track material performance issues, actions, accountable owners, expected impact, and results through resolution
• Use forecast-to-actual findings to identify assumptions that should be revisited and opportunities to improve future performance management
   

Manage Government Programs Clinical Pharmacy Reporting & Analytics Requirements

• Serve as the business owner for Government Programs Clinical Pharmacy reporting and analytics requirements, with primary focus on Part B and Part D
• Define business requirements, priorities, and enhancement needs for Part B and Part D pharmacy performance dashboards
• Partner with the CPO, Formulary Strategy, HCE, Analytics, Finance, and Actuarial to develop and continuously improve reporting capabilities needed to understand pharmacy performance
• Define required metrics, business definitions, data views, drill-down capabilities, and reporting frequency
• Identify gaps in current reporting and maintain a prioritized roadmap based on business and leadership needs
• Ensure Part B and Part D can be evaluated independently and collectively to provide a holistic view of Government Programs drug performance
• Promote consistency in data definitions and reporting so Pharmacy, Finance, Actuarial, HCE, and other partners are working from a common set of facts
• Identify opportunities to improve reporting and performance management through analytical approaches, automation, and appropriate use of AI-enabled capabilities
• Serve as a primary resource for new Clinical Pharmacy reporting needs and help determine the appropriate analytical or reporting solution
   

Identify & Support Affordability Opportunities and Improved Approaches

• Use drug trend, utilization, financial performance, market information, and relevant industry practices to identify areas where affordability or performance-management opportunities should be evaluated
• Recommend improvements to drug-trend management, affordability measurement and implementation, Part B and Part D reporting, and pharmacy performance management
• Partner with Pharmacy Strategy, Industry Relations, Clinical Pharmacy, Finance, and other teams to evaluate identified opportunities and determine appropriate next steps
• Bring utilization and financial insights into Industry Relations discussions to identify areas where contracting, rebate, sourcing, or other market-based opportunities should be explored
• Assess potential affordability opportunities using utilization, trend, financial, clinical, operational, and market information
• Identify where existing approaches may need to change based on performance, market developments, or relevant industry practices
• Explore practical applications of AI and automation that may improve drug-trend identification, affordability measurement, reporting, performance management, or pharmacy operations
• Connect identified opportunities to the appropriate Strategy, Clinical, Industry Relations, Operations, Analytics, or other functional owner for further evaluation, decision-making, and implementation
• Monitor results and use lessons learned to recommend improvements or broader application across Government Programs Pharmacy
   

Support Cross-Functional Clinical Pharmacy Solutioning

• Serve as a Clinical Pharmacy resource for cross-functional Optum Rx issues involving RxClaims, pharmacy capabilities, reporting, or operational solutions that require coordination across multiple teams
• Partner with Clinical Pharmacy Operations, Optum Rx, and other enterprise teams to investigate issues, understand root causes, and identify practical solutions
• Translate Clinical Pharmacy business needs into clear requirements and connect the appropriate clinical, technical, operational, and business resources
• Identify recurring or systemic issues where changes to a pharmacy capability, process, claims solution, or operating model could provide broader value
• Partner with accountable Product, Technology, Operations, and Optum Rx teams to evaluate potential solutions for business fit, member impact, operational implications, and alignment with Government Programs Pharmacy objectives
• Coordinate issues toward a clear solution, accountable owner, or decision and escalate barriers when leadership intervention is required
   

Support CPO Priority Projects & Business Problem Solving

• Lead or support priority, time-sensitive, or ambiguous pharmacy business issues at the direction of the CPO, particularly where work spans multiple functions or does not have a clear single owner
• Assess the business question, determine the information and expertise required, and engage the appropriate partners
• Conduct analysis and problem solving involving pharmacy performance, affordability, claims, operations, reporting, financial performance, or other areas aligned with the role's expertise
• Apply pharmacy expertise and business judgment to structure issues and identify practical paths forward
• Develop concise, decision-ready materials that clearly articulate findings, implications, options, and recommended next steps
• Represent Clinical Pharmacy in selected cross-functional initiatives when appropriate
• Support discrete strategic or operational initiatives assigned by the CPO while maintaining accountability for the role's core drug-trend and affordability responsibilities

Core Deliverables

• Integrated Part B + Part D Performance View
• Consolidated view of drug spend, utilization, trend, key drivers, forecast-to-actual performance, affordability results, and emerging risks
• CPO Drug Trend & Affordability Review
• Recurring review of material performance changes, drivers, affordability results, opportunities, decisions, accountable owners, and follow-through
• Forecast-to-Actual & Affordability Performance View
• Clear view of expected versus actual pharmacy performance, underlying variances, affordability initiative performance, realized value, and value at risk
• Clinical Pharmacy Reporting Roadmap
• Prioritized Part B and Part D reporting requirements, gaps, dashboard enhancements, and future analytical needs
• Drug Trend & Affordability Insights
• Internal perspectives on emerging drug-trend and affordability issues, relevant market and industry practices, and opportunities to improve Government Programs Pharmacy performance

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: 

• Doctor of Pharmacy (PharmD) degree with solid knowledge of managed care pharmacy, Medicare Part D, medical benefit/Part B drugs, specialty pharmacy, pharmacy economics, pharmacy claims, and pharmacy operations
• Demonstrated expertise in drug trend and affordability performance, including drug spend, utilization, unit cost, mix, forecast-to-actual analysis, affordability performance, and the clinical, financial, market, and operational factors that drive pharmacy trend
• Ability to integrate and interpret complex clinical, financial, utilization, market, and operational information and translate findings into clear business insights, recommendations, and leadership-ready narratives
• Demonstrated ability to develop informed perspectives on emerging drug trends, affordability challenges, and relevant industry practices, benchmark current approaches, identify opportunities for improvement, and apply insights to Government Programs Pharmacy
• Demonstrated ability to identify, evaluate, and recommend practical solutions to complex business problems, including opportunities to improve drug-trend management, affordability, reporting, performance management, pharmacy operations, and appropriate use of AI or automation
• Proven solid cross-functional collaboration and influencing skills, with demonstrated ability to work effectively and drive outcomes across Finance, Actuarial, HCE, Analytics, Strategy, Industry Relations, Clinical Pharmacy, Operations, and PBM/Optum Rx organizations
• Ability to translate business needs into actionable reporting, analytical, claims, and operational requirements, including development and prioritization of dashboard and reporting needs
• Demonstrated solid business judgment and independent problem-solving ability, including the ability to distinguish material performance signals from normal variation, structure complex or ambiguous questions, develop recommendations, and drive issues toward resolution
• Proven solid communication, presentation, and business storytelling skills, with the ability to communicate complex pharmacy performance and recommendations clearly to senior leaders and business partners
• Ability to serve as a trusted internal subject matter expert on Part B and Part D drug trend and affordability performance and effectively support CPO and Government Programs Pharmacy leadership
• Ability to operate effectively as an individual contributor in a highly matrixed organization, managing multiple priorities and delivering results with limited direction

*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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.