Job Description
We're seeking a leader to drive Payment Integrity Non-Clinical Vendor Insourcing in Dublin or Letterkenny, with a hybrid work model. The role involves driving medical cost savings growth by ensuring payment accuracy, and identifying opportunities for improvement. The successful candidate will be an accomplished innovator with analytical and growth mindset, able to comprehend claim leakage trends and develop innovative solutions. Key responsibilities include providing ideation and growth leadership, leading non-clinical leakage detection governance, and partnering with data and analytic teams to ensure enabling capabilities are fully aligned. The ideal candidate will have a proven track record in delivering high value improvement results within a business, using data and technology as the key lever. They will also have excellent interpersonal skills, and the ability to work across all functional areas. Key skills include strong conceptual and analytical skills, with a focus on operational solutions and benefit realization. The company offers flexible work arrangements, and individuals will have the opportunity to split their monthly work hours between the Dublin or Letterkenny offices and telecommuting from a home-based office. The company is committed to mitigating its impact on the environment and enabling equitable care that addresses health disparities and improves health outcomes. 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.
Key responsibilities:
Provide ideation and growth leadership specifically focused on the identification and resolution of Payment Integrity claim leakage through data, analytic and operational solutions
Lead non-clinical leakage detection governance, including claim leakage oversight and business intelligence
Lead large-scale data, analytic and utility change within a matrix environment with a focus on claim leakage detection, operational solutions and associated benefit realization
Partner with data & analytic and engineering teams to ensure enabling capabilities are fully aligned
Establish data and business controls to ensure growth opportunities are sourced and vetted appropriately prior to development and/or deployment
Support the design and functioning of competitive intelligence processes to enable ideation lead generation and external / internal content opportunities
Take a client agnostic lens and lead large-scale data and analytic change within a matrix environment with a focus on claim leakage detection and operational solutions
Required qualifications:
Bachelor's degree or commiserate experience
Proven experience in leading data, analytic and technology change within a matrix environment with a focus on operational solutions and benefit realization
Proven experience implementing business transformation initiatives from ideation to successful delivery
Previous experience in 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
Extensive 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