Sr Director, Product - Payment Integrity - Remote

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives?  Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

Shape the future of payment integrity by leading Optum's Clinical and Coding Review product portfolio and building the next generation of AI-enabled solutions that improve payment accuracy and healthcare affordability.

The portfolio includes established, scaled solutions as well as emerging capabilities addressing complex clinical, coding, reimbursement and payment accuracy challenges across the claim lifecycle.

You will determine where we invest, modernize, build, buy, partner, scale and rationalize as advances in AI, analytics and healthcare reimbursement reshape payment integrity. You will own the product vision and multi-year roadmap and drive measurable outcomes across client value, affordability, growth, adoption and financial performance.

This is a highly visible leadership role with significant influence across Product, Technology, AI/Analytics, Operations, Finance and Commercial teams, as well as with clients and senior Optum leadership.

Why This Role

Lead at scale. Own the strategy and evolution of an established Clinical and Coding Review product portfolio serving complex healthcare organizations, with accountability for its continued growth, performance and market differentiation.

Shape what comes next. Define how AI, advanced analytics, automation and new product capabilities can transform clinical and coding review, improve payment accuracy and affordability, and create better experiences for payers and providers.

Make consequential portfolio choices. Set investment priorities across existing and emerging solutions, balancing near-term client and business needs with modernization, scalability and long-term strategic advantage.

Influence at the enterprise level. Shape investment, client and go-to-market decisions while aligning senior leaders across Product, Technology, Analytics, Operations, Finance and Commercial teams.

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:  

• Lead Portfolio Strategy and Performance
  • Define and own the vision, strategy, multi-year roadmap and investment priorities for the Clinical and Coding Review portfolio
  • Translate client needs, reimbursement trends, competitive dynamics, technology advances and business performance into clear portfolio choices across growth, modernization, new products, partnerships and rationalization
  • Drive portfolio performance across growth, affordability impact, client value, adoption, product health and financial outcomes
  • Partner with Finance, Operations and Commercial leadership on business plans, commercialization, pricing, packaging and value realization
  • Apply disciplined portfolio management to decisions across build, buy, partner, modernize, scale and rationalize based on client value, strategic differentiation and return on investment
• Build the Next Generation of Clinical and Coding Review
  • Lead the evolution of established products while identifying and developing new capabilities that address emerging clinical, coding and reimbursement challenges
  • Identify where AI, advanced analytics and automation can materially improve clinical and coding accuracy, reviewer productivity, scalability, client value and payer and provider experiences
  • Partner across Technology, AI/ML, Analytics, Data Science and Operations to translate those opportunities into responsible, scalable and commercially viable products
  • Balance near-term client and business priorities with platform modernization, shared capabilities and long-term portfolio strategy
• Build and Lead a High-Performing Product Organization
  • Lead, coach and develop product leaders and teams responsible for products and capabilities across the portfolio
  • Establish clear accountability, decision rights and outcome-based product management practices.
  • Create alignment across Product, Technology, Analytics, Operations, Finance and Commercial leadership around priorities, investment decisions and execution
  • Partner with Payment Integrity leadership to shape broader product, platform, investment and business strategy
• Lead Market and Client Strategy
  • Serve as the senior product leader for the portfolio with strategic clients, industry stakeholders and executive audiences
  • Lead executive-level discovery and roadmap discussions to uncover unmet needs, validate opportunities and inform investment decisions
  • Anticipate changes in reimbursement, policy, technology, AI, payment models and payer and provider behavior to identify new opportunities and risks
  • Partner with Commercial leadership to strengthen Optum's market position and articulate a differentiated Clinical and Coding Review value proposition

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:

• 10+ years of experience in product management, portfolio leadership, technology-enabled healthcare solutions, platform leadership and/or business transformation
• 8+ years of healthcare experience, with significant experience in payment integrity, healthcare payments, reimbursement, claims, revenue cycle management, clinical solutions, coding solutions or closely related domains
• Demonstrated experience leading a portfolio of products, major product lines or complex enterprise solutions with accountability for strategy, investment priorities and measurable business and client outcomes
• Experience developing multi-year product and portfolio strategies and translating them into investment roadmaps, commercialization plans and execution priorities
• Experience leading technology-, data-, analytics- and/or AI-enabled products in complex enterprise environments
• Experience with go-to-market strategy, including positioning, pricing, packaging, launch readiness, growth strategy and value measurement
• Demonstrated success leading product leaders and teams and influencing senior executives across highly matrixed organizations
• Proven ability to use financial, market, operational and product data to evaluate investments, manage portfolio tradeoffs and translate complex healthcare challenges into scalable product strategies
• Demonstrated executive communication and influence skills, including the ability to create alignment around complex strategic decisions

Preferred Qualifications:

• Experience in business strategy, technology, healthcare or product leadership
• Experience leading product portfolios within healthcare payment integrity, claims, reimbursement, revenue cycle, clinical review or coding review
• Experience launching and scaling enterprise B2B, SaaS, data, analytics or AI-enabled products in complex, regulated environments
• Experience applying AI, machine learning or advanced analytics to clinical decision support, coding, payment review, workflow automation or healthcare affordability
• Deep knowledge of healthcare reimbursement methodologies, clinical and coding review, provider revenue cycle, reimbursement policy, claims payment and/or health plan affordability
• Working knowledge of Optum and/or UnitedHealth Group
• Direct payment integrity experience is highly valued; candidates with deep experience in adjacent claims, reimbursement, clinical/coding, revenue cycle or healthcare technology domains who have demonstrated success leading complex product portfolios are also encouraged to apply

*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 $159,300 - $273,200 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.