Capability Manager- PBM Pricing - Remote

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.  

OptumRx is boldly leading the PBM industry in helping our members, clients, and prescribers understand the value of their benefits and optimal ways to utilize them. Be in the pilot's seat as healthcare is transformed by joining the PBM Pricing Capability team as an API Services Capability Manager.

In this role, you will be instrumental in supporting our existing and rapidly expanding consumers of PBM Pricing Capability insights. The individual filling this role will own and drive the end-to-end lifecycle of API connectivity, serving as a primary point of coordination for over 70+ consumer integrations, with continued growth expected. You will also have opportunities to expand into other aspects of benefit transparency as the capability evolves.

This role requires effective communication and collaboration skills, a consultative approach to stakeholder engagement, the ability to put forward creative solutions, solid attention to detail, and the ability to define and build repeatable/reusable processes that enable scalability.

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: 

Consuming Application Management:

• Own the intake, governance, and lifecycle management of PBM Pricing Capability APIs (>70 integrations), serving as the primary liaison between consumer teams and downstream service teams. Support onboarding of new consumers and ongoing optimization of existing integrations
  

Support PBM Experience Consistency:

• Drive consistency in the PBM member and prescriber experience by partnering across capability, product, and technology teams to ensure APIs and downstream integrations deliver aligned, accurate, and predictable outcomes across all consumer touchpoints
  

Compliance & Risk Management:

• Ensure strict compliance with regulatory, privacy, and security standards, including adherence to pricing transparency and representation requirements
  

Stakeholder Engagement:

• Initiate and lead collaborative discussions with a broad range of stakeholders including Product, Underwriting, Sales, Marketing, Technology, Operations, and Reporting. Serve as a trusted, consultative partner to align on requirements and guide effective use of the capability
  

Productize / Monetize:

• Establish and advance an API product strategy that enables monetization, scalability, and enterprise reuse-transforming integrations into standardized, value-generating capabilities
  

Innovation & Optimization:

• Identify opportunities to enhance capability performance, scalability, and consumer experience through automation, AI/ML, and advanced analytics
  

Change Management:

• Lead change management for API modernization initiatives by planning, coordinating, and executing the transition from legacy integrations to modern architectures
  

Process Design & Scalability:

• Define, implement, and continuously improve repeatable/reusable processes to support a growing number of integrations and stakeholders efficiently and at scale

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 in product/capability development or product/capability management, preferably in healthcare or PBM
• 5+ years working in a matrixed organization and across cross-functional teams
• Demonstrated familiarity with APIs, data integration, and system interoperability
• Proven solid communication, stakeholder engagement, and executive presence
• Demonstrated ability to operate in a consultative capacity across diverse stakeholder groups
• Proven solid analytical skills with experience in developing business cases, financial modeling, and data-driven decision-making
• Experience with process improvement, operational design, and building scalable workflows

Preferred Qualifications: 

• Project management experience or certification (formal or demonstrated through experience managing complex, multi-stakeholder initiatives)
• Experience in the healthcare industry
• Experience in the Pharmacy and/or PBM industry
• Demonstrated ability to leverage data, analytics, and emerging technologies to operate and scale capabilities (e.g., automation, AI/ML, or advanced reporting)
• Experience working in Agile methodology

*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 $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.