Fraud Operations Manager - Commercial Payments - 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.

Optum Financial protects customers and the business by preventing and responding to fraud. The Fraud Operations Manager leads day-to-day fraud operations for the Commercial Payments portfolio (e.g., ACH, virtual card, and check), spanning monitoring and triage, investigations, case management, reporting, and continuous improvement. This role owns operational performance and controls and leads response for complex or high-risk incidents to support loss mitigation, regulatory reporting, and audit readiness.

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:

• Fraud Operations Execution & Control Ownership: Own day-to-day fraud operations across monitoring/triage, investigations, and case management to protect customers and the business through timely, consistent execution. Establish and maintain operational controls (intake standards, documentation requirements, quality checks, and audit-ready case files) aligned to policy and regulatory expectations and ensure procedures/playbooks remain current and consistently followed. Coordinate with key partners (e.g., Treasury, Compliance, Fraud Strategy, Product, Technology, and Operations) to resolve operational bottlenecks, drive control improvements, and support loss mitigation
• Investigations Leadership & Incident Response: Lead the investigation lifecycle from intake and triage through resolution, including case assignment and prioritization. Coordinate timely engagement with leadership, Legal, and Compliance for complex, sensitive, or high exposure matters per policy. Ensure investigative conclusions are well-supported, clearly documented, and consistently aligned to standards
• Monitoring, Queues & Case Management: Oversee fraud monitoring outputs (dashboards, alerts, and reports) that drive investigative triggers and identify repeat-risk indicators. Manage queues and workload distribution to maintain coverage, timeliness, and consistent application of prioritization criteria. Maintain disciplined case management (creation, categorization, key indicator capture, and complete case files) to support service-level expectations and documentation standards
• Operational Insights, Root Cause & Improvement: Lead root-cause analysis for confirmed fraud events, near-misses, and significant incidents to identify control breakdowns and process gaps. Translate findings into clear, prioritized recommendations and operational playbook updates (procedures, triage criteria, and investigator guidance). Drive follow-through on remediation plans and assess whether corrective actions are implemented and effective
• Operational Reporting & Stakeholder Communication: Provide routine operational reporting (volumes, losses, outcomes, backlog, incident drivers, and emerging risks) and summarize key themes for key stakeholders. Establish a predictable reporting cadence (e.g., weekly case health and incident updates; monthly trend and root-cause themes) aligned to stakeholder needs. Track and communicate performance against service-level expectations and quality standards (e.g., timeliness, completeness, and documentation quality) and coordinate inputs as needed to support regulatory reporting and audit readiness

Why Join Us:

You'll be rewarded and recognized for your performance in an environment that challenges you and provides clear guidance on what is needed for success. We offer development opportunities for future career growth, and you will be part of a mission-driven team that leverages data, technology, and innovation to protect customers and enhance the security of healthcare and commercial financial transactions. We are committed to diversity and inclusion - as an Equal Opportunity Employer, Optum Financial (part of the UnitedHealth Group family of businesses) welcomes candidates from all backgrounds and experiences to apply. If you are passionate about fighting fraud and leading teams to make a tangible impact, we encourage you to join us in building a more secure financial future for our clients and communities.

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 fraud operations and/or fraud investigation, preferably within healthcare payments, financial services, and/or fintech environments
• 2+ years of people leadership experience, managing investigators/analysts (or equivalent leadership in a fraud, risk, or financial crimes environment), including coaching to service-level expectations and investigation quality standards
• Demonstrated experience leading complex fraud investigations end-to-end and serving as a lead for complex or high-risk matters, with consistent application of policy, sound investigative judgment, and clear documentation
• Experience managing operational workflows (queues, backlogs, prioritization criteria, and reporting cadence) to maintain coverage, timeliness, and consistent execution
• Hands-on experience with case management systems (ex. Salesforce, Navex Global) and proficiency in extracting data from tools used for operational reporting and analysis (e.g., Excel and business intelligence (BI)/reporting tools)
• Demonstrated ability to establish and maintain operational controls (intake standards, documentation requirements, quality checks) and drive continuous improvement through root-cause analysis and process enhancements
• Proven solid analytical and critical-thinking skills, including experience performing in-depth fraud root cause analysis, trend review, and using data to drive operational decisions
• Proven excellent written and verbal communication skills, with the ability to document investigative work clearly and deliver concise operational updates and risk insights to varied stakeholders

Preferred Qualifications:

• Relevant industry certifications such as Certified Fraud Examiner (CFE) or Certified Anti-Money Laundering Specialist (CAMS) are a plus (demonstrating formal expertise in fraud investigations and financial crimes compliance)
• Experience with commercial payment methods and platforms, including supporting ACH, virtual card, and check payment processes
• Experience in commercial (B2B) payment or financial services environments with significant fraud risk exposure
• Proven experience collaborating with fraud strategy, risk management, analytics, product, and operations teams to translate operational and investigative findings into preventive controls, workflow improvements, or process enhancements
• Experience improving fraud operations through workflow optimization, playbook development, or tooling enhancements (e.g., alert tuning, case routing, reporting automation)
• Familiarity with fraud incident management/response frameworks, recovery, and chargeback processes, and applicable AML/BSA concepts, including experience supporting regulatory inquiries, investigations, or audit examinations

*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.

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.