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.

We are seeking a Senior Strategic Account Executive with a primary focus on Medicare and Medicaid Sales and Strategy to support our esteemed Health Plan client, which boasts an annual revenue of approximately $2 billion. This role is critical in driving growth, ensuring compliance, and fostering strategic partnerships within the healthcare and pharmacy benefit management (PBM) sectors. The ideal candidate will be a seasoned client management executive with a deep understanding of regulatory affairs and a proven track record of success in contract management and negotiations.

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

Primary Responsibilities:

• Identify and develop strategic opportunities to enhance client satisfaction and drive business growth

• Formulate and execute strategies to ensure client compliance with Federal and State regulations governing Medicare and Medicaid programs

• Collaborate with subject matter experts (SMEs) to develop tailored Medicare strategic initiatives, including initiatives related to STARs, Plan Finder, and Medication Therapy Management (MTM)

• Oversee contract compliance and negotiations, ensuring the successful execution of contract service delivery for Medicare and Medicaid, including audits, service level agreements (SLAs), and contract renewals

• Participate in market check processes and client renewals, providing strategic insights and recommendations to drive client retention

• Identify and capitalize on opportunities for cost avoidance, offering innovative solutions to enhance client satisfaction and operational efficiency

• Provide oversight and guidance on client implementation of new CMS, state, and federal requirements, ensuring seamless integration and adherence to regulatory standards

• Lead reporting efforts and deliver data analytics, such as Quarterly Performance Reviews (QPR), to facilitate informed decision-making and enhance client engagement

• Provide operational oversight, identifying opportunities to optimize regulatory compliance and operational effectiveness

• Assume overall responsibility for audits and serve as a subject matter expert for Medicare and Medicaid annual readiness assessments

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 Medicare and Medicaid, with a solid emphasis on regulatory and compliance aspects

• 5+ years of experience in healthcare or PBM account management, demonstrating a successful track record in client management and retention

• 3+ years of experience leading upsells and growth activities, with a demonstrated ability to identify and capitalize on business opportunities

• Experience in relationship building, both internally and externally, with solid matrix management skills

• Proficiency in utilizing PBM tools to create marketing materials, respond to requests for proposals (RFPs), and generate financial and data reports

• Proven excellent executive-level communication skills, with the ability to effectively communicate complex concepts and strategies

• Willingness to travel up to 25% of the time to meet client needs and attend relevant industry events

Preferred Qualifications:

• Experience in PBM or health plan environments

• Extensive knowledge of CMS requirements and regulations governing Medicare and Medicaid programs

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.