Job Description
Director, Payment Integrity Non-Clinical Vendor Insourcing Leader
Optum is a global healthcare company that delivers care and technology to help millions of people live healthier lives. As a Director, Payment Integrity Non-Clinical Vendor Insourcing Leader, you will play a critical role in driving the development and execution of medical cost savings growth for UnitedHealthcare and Commercial client health plans.
About the Role:
As a key member of the Non-Clinical Operations Payment Integrity team, you will be responsible for leading solution paths to support process improvements and transformation change with a specific focus on improving claims audit outcomes within our Operations that serve the United Healthcare business.
Key Responsibilities:
- Develop and steer strategy for Payment Integrity Affordability, delivering vendor insourcing and growth opportunities for United Healthcare.
- Lead large-scale data, technology, and application change within a matrix environment with a focus on operational solutions and benefit realization.
- Develop and agree operational requirements, resources, and business requirement documents in partnership with finance, workforce management, and value streams as part of the insourcing strategy.
- Provide oversight on the portfolio of insourcing initiatives operationalized within value streams to achieve revenue and market share targets, contributing to medical cost savings growth and operating cost efficiency.
- Support the design and production of competitive intelligence infrastructure to enable preemptive action on external and internal factors that provide vendor opportunity.
- Lead and directly support operations insourcing subject matter experts across the non-clinical value streams.
- Partner with Operations leadership, Analytics, Research & Development, Technology, and Quality teams to ensure insourcing initiatives and strategies are implemented effectively.
- Work across the teams and with business partners to identify additional affordability opportunities and delivery on organization/team MBOs.
Requirements:
- Bachelor's degree or commensurate experience.
- Proven previous experience in leading large-scale data, technology, and application change within a matrix environment with a focus on operational solutions and benefit realization.
- Proven experience in implementing business transformation initiatives from ideation to successful delivery.
- Influencing and understanding the necessary and appropriate actions to ensure maximization of financial results and objectives.
- Proven track record in delivering high-value improvement results within a business using data and technology as the key lever.
- Project Management and/or Scrum certifications.
- Experience working with the ideation, development, and deployment of initiatives for in-year and multi-year benefit realization.
- Previous experience working in a highly matrixed organization.
- Strong conceptual and analytical skills.
- Excellent interpersonal skills, ability to work across all functional areas, as well as business partners.
Preferred Qualifications:
- Knowledge of the US Healthcare industry, major healthcare entities, and claims lifecycle.
- Proficiency at a senior management level within a multi-national enterprise with experience of leading 100+ professionals through a technology change cycle.
About Optum:
At Optum, 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:
Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law.