Sr. Consultant (Payer Operations) Optum Advisory - 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.

The Sr. Consultant (Payer Operations) Optum Advisory - Remote works within an Optum Advisory delivery team and serves a key role in contributing to engagement work products, project execution, and business management activities. This role structures and conducts analysis, creates client-ready content for assigned workstreams, and contributes to problem solving across the full scope of each project.

Success in this role requires healthcare payer operations experience, strong analytical and financial problem-solving skills, and the ability to independently manage assigned workstreams while supporting junior team members. The role will lead client communications related to assigned workstreams, proactively identify risks and issues, and make sound recommendations to improve project delivery and client outcomes.

Role emphasis: Independent workstream delivery, analytics, client-ready deliverables, team problem solving, knowledge management, and emerging consulting leadership.

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:
Client Engagement Delivery and Workstream Leadership:

• Structure the approach and analysis for assigned workstreams largely independently, with guidance from the Project Manager or engagement leadership as needed.
• Develop and deliver client-ready work products, including analyses, process documentation, current-state and future-state materials, issue summaries, recommendations, and presentation content.
• Lead client communications related to assigned workstreams and, at times, support communications for work performed by more junior team members.
• Establish timelines for assigned workstream activities and assist junior team members with timelines, deliverables, and follow-through in accordance with overall project requirements.
• Serve as a major contributor to team problem solving across the full project scope, including structuring and facilitating problem-solving sessions with support from the Project Manager.
• Proactively anticipate challenges, dependencies, and risks within assigned areas and make practical adjustments or recommendations to address issues.
• May serve as project lead for smaller, more templated engagements or work in familiar payer operations terrain.
• Communicate effectively and accurately in writing and verbally with clients, prospects, team members, and practice leaders.

Payer Operations and Analytical Contribution:

• Apply payer operations knowledge across domains such as claims operations, payment integrity, provider operations, member and provider services, appeals and grievances, compliance, operational reporting, and performance management.
• Conduct data analysis and financial analysis to identify issues, root causes, business impacts, and practical solution options.
• Translate analysis, stakeholder input, and project findings into clear insights and actionable recommendations.
• Build credibility as a knowledgeable contributor on payer operations topics and maintain a foundational understanding of healthcare industry dynamics.
• Maintain awareness of Optum data sets, tools, research, assets, and methods used by the practice to support client delivery.

Practice Development and Team Contribution:

• Lead or participate in practice development projects, including business process improvement, knowledge management, reusable assets, and internal capability building.
• Support junior team members by helping them structure work, understand expectations, improve deliverable quality, and meet project timelines.
• Contribute to a collaborative, team-oriented work environment that encourages high-quality delivery, learning, and practical solutions.
• Participate in internal initiatives that strengthen client delivery, improve consistency, and advance the maturity of payer operations offerings

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:

• 3+ years of relevant healthcare work experience, including healthcare insurance, healthcare operations, or healthcare management consulting
• 3+ years of experience across multiple lines of healthcare payer business, including Commercial, Medicare, Medicaid, ACA, and Family/Individual coverage, among others
• 3+ years of experience with payer operations in one or more areas such as claims operations, payment integrity, provider operations, member/provider services, operational controls, reporting, or financial performance
• 3+ years of experience in data analysis and financial analysis
• 3+ years of experience with Program and operational coordination including tracking, presentation, reporting, timeline management, and follow-through
• Ability to travel up to 50%

Preferred Qualifications:

• 2+ years of external client-facing experience at a consulting firm, including Big 3, Big 4, Big 6, boutique, or comparable advisory experience
• Payment Integrity experience, including audit, recovery, prevention, payment accuracy, claims editing, vendor operations, or operational optimization initiatives
• Experience applying process improvement or implementation methodologies such as Lean, Six Sigma, Agile, or similar approaches
• Experience mentoring, coaching, or assisting junior-level staff
• Demonstrated ability to structure analytical reasoning and solution-focused problem solving
• Ability to participate in and contribute to cross-functional teams
• Ability to work in complex, highly matrixed, fast-paced environments
• Solid interpersonal and relationship-management skills, including demonstrated customer or client-facing experience
• Solid written and verbal communication skills, including the ability to develop clear, client-ready presentations and work products

*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.