Director of Optum Payment Integrity – 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 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. 

As the Director of Optum Payment Integrity, you will support, enable and lead the Payment Policy growth, ideation and operations teams to achieve their monthly and annual goals. Payment Policy is a critical function in the Payment Integrity business. It’s primarily responsible for developing new reimbursement policies and maintaining the integrity of our existing policies to help ensure claims are paid accurately. This is a dynamic, high-profile business unit which has had significant growth in the last 1-3 years. The role holder will balance their time between successfully leading the operations teams; supporting growth and affordability ideation and innovating our business processes to yield higher outcomes; and partnering closely within a stakeholder matrix to champion business growth.   

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

Primary Responsibilities:

• Leading the team in achieving annual targets, ensuring the completion of new policy deployments as planned, and monitoring and analyzing business process information
• Maintaining and auditing robust quality and control management processes
• Conducting capacity planning and prioritization of business processes across the team and broader payment policy pipeline to drive affordability and compliance
• Managing SLAs and key performance measures by providing measurement, monitoring, and reporting to business stakeholders on performance, results, and action planning
• Collaborating with stakeholders to drive operational ideation and growth, focusing on optimization, creation, and maintenance of edits to meet business objectives
• Developing and implementing a business-level strategy to enhance the operating model, promote horizontal growth, and improve process efficiency
• Identifying opportunities to streamline and automate operations processes, including leveraging new technology, content sourcing, and tools/utilities
• Providing leadership presence in people and talent management, ensuring a positive employee experience and emphasizing development, inclusion, and diversity

By effectively carrying out these responsibilities, you will contribute to the achievement of organizational goals and drive the success of the Payment Policy Operations team.

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:

• 7+ years of experience with UHC claims systems or support
• 7+ years of experience with UHC Payment Policy either through implementation, sourcing or maintenance
• 5+ years of experience in delivering executive level presentations
• 5+ years influencing and understanding the necessary and appropriate actions to ensure maximization of financial results and objectives 
• 3+ years of experience working with the ideation, development, and deployment of initiatives for in year and multi-year benefit realization
• 3+ years of experience directly managing a team of 20+ resources onshore / offshore
• Experience working in a highly matrixed organization

Preferred Qualifications:

• AAPC or AHIMA certification
• Project Management and/or Scrum certifications
• Demonstrated conceptual and analytical skills
• Demonstrated excellent interpersonal skills with the ability to work across all functional areas, as well as business partners

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $122,100 to $234,700 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.