Director, Claim Pricing – 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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
 

Be part of this enterprise-wide claims transformation journey! The Claim Product and Data (CPD) team’s vision is to reimagine and simplify the end-to-end claim experience by providing a nimble and frictionless claim capability for all constituents, driving maximum affordability. The work will be challenging and rewarding!

 

This role will be accountable for partnering with leaders to define the strategy and roadmap for end-to-end pricing, in support of enterprise objectives. Pricing is critical to our business, helping us get from billed amount to allowed amount, and generating significant savings for our customers and our members. By streamlining and modernizing the pricing capability across the enterprise, you will have the opportunity to touch countless lives.

 

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

 

Primary Responsibilities:

• Define and drive the enterprise pricing strategy
  • Drive operational insights
  • Prioritize critical business opportunities
  • Evaluate and adopt emerging technologies such as AI and machine learning
  • Develop strategic plans and roadmaps for cross-platform pricing capability
  • Bring thought leadership, consultative mindset, and pricing expertise to drive transformational change across other teams’ vision (e.g. Provider, OptumCare)
• Provide delivery oversight of the Enterprise Pricing Platform (EPP, comprised of GGMAP, ppoONE, PSI), which processes 24mn claims (2025 YTD)
• Be accountable for completion of strategic, capital-funded CPD initiatives, overseeing the team of 14 onshore and offshore business resources who:
  • Define the business requirements and coordinate work across multiple technology teams 
  • Write and prioritize customer-focused features and capabilities
  • Manage capital spend within budget
  • Mentor and develop team members, promoting a culture of continuous improvement, accountability, and professional growth
• Oversee additional activities that support and accelerate pricing strategy and/or delivery:
  • Provide oversight and expertise into process mapping that helps to identify and quantify pricing opportunities
  • Create business cases and economic analyses to drive cost-effective solutions
  • Build compelling stories to support initiatives, gain buy-in, and report out on success to various audiences (inc. executive presentations, GCO playbooks, etc.), leveraging data and insights
  • Establish robust business workforce planning and inform tech resource planning to ensure all key priorities can be delivered in a timely manner
• Establish a solid network of stakeholders and promoters to support and enable the pricing strategy, by:
  • Represent CPD in executive forums and cross-functional leadership meetings, articulating the pricing value to the company
  • Report out to cross-functional stakeholders about continued progress on development and its impact (financial and other benefits)
  • Engage with external stakeholders including vendors, partners, and regulatory contacts to ensure the best pricing technologies are available in a cost-effective manner. 
  • Maintain solid relationships with all claim teams, shared services and business partners to influence value capture, execution and prioritization of identified initiatives
  • Ensure integration across all CPD claim capabilities and strategies – closing gaps, addressing opportunities, and furthering CPD vision and strategy

 

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 in business operations or working closely with business operations
• 5+ years in strategy development and planning, project management and transformational and change management practices
• 5+ years of program management experience or managing through significant change initiatives with vision, roadmap, plan
• 5+ years of matrixed leadership experience with matrixed cross functional / cross segment teams experience / cross discipline
• Proven experience leading and supporting a team of direct reports
• Demonstrated experience building effective relationships with leadership
• Demonstrated vision and strategy formulation and demonstration of critical thinking skills, including experience developing and executing a long-term plan
• Demonstrated growth mindset, with an appetite for ambiguity and energy to tackle the new, different and unique challenges, frequently requiring operation at the intersection of business and technology
• Intermediate or above proficiency with PowerPoint and Excel
• Experience in pricing and/or contracts
• Health care claims, customer service, provider service, or digital experience

 

Preferred Qualifications: 

• Experience in technology development and/or Agile frameworks
• Proven systems thinking, with proven ability to manage a high degree of complexity and facilitate cross-organization partnership
• Demonstrated enterprise insight and understanding, with an ability to see the big picture and align/integrate plans to achieve goals
• Proven task and project management skills, with an ability to define goals, align resources and deliver on time and within budget
• Aha experience

 

*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 $132,200 to $226,600 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 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.