Payment Integrity Operations Lead

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.

This position will lead our efforts to provide Account Operations Leadership to support AZ residents and operate the scope of work initially for Payment Integrity ("PI") and subsequently Claims Editing System ("CES") and Optum Payment Recovery System ("OPRS").  This role is accountable for end-to-end operational delivery, talent/leadership development, and financial & cost management.  This role will have direct Client interaction in partnership with Account Leadership.   

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.   

Primary Responsibilities:

• Operational performance of $20M revenue business including a team of individual contributors, leaders, and support roles to exceed client expectations
• Full accountability for performance delivery and achievement of service level agreements 
• Serve as a catalyst for change, driving continuous improvement to increase effectiveness, client satisfaction, and operating efficiency
• Develop and foster solid leadership relationships with internal partners and customers
• Communicating operational strategies and performance results to internal leaders and external clients 
• Break down organizational barriers, build alliances, and gain consensus to ensure results are obtained
• Making critical business operations decisions, often with imperfect information or incomplete facts
• Developing, prioritizing, and securing funding for investments to strengthen infrastructure of systems, processes, and talent 
• Monitoring business results and managing day to day performance of the operations staff
• Leadership development and succession planning
• Meeting Internal Operating Income ("IOI") and expense targets

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 solid leadership and strategic planning skills within a matrix environment
• 10 years operational management experience
• 5 years supporting delivery of fraud waste and abuse analytics, preferably in Medicaid
• 5 years in supporting, delivering solutions leveraging a deep understanding of healthcare medical claims and encounters, eligibility and provider data
• Demonstrated to be self-starter, able to independently lead with minimal oversight
• Demonstrated excellent verbal and written communication skills
• Demonstrated high level of analytic and financial capability
• Proven solid interpersonal skills, ability to work with all levels of management, staff, and external clients
• Proven solid problem-solving skills - able to creatively solve challenges using short and long term strategies
• Proven ability to produce superior results in a customer driven environment
• Proven ability to lead teams through rapidly changing or difficult business environments
• Proven ability to simplify the complex and identify critical levers for business performance and client needs
• Ability to travel up to 50% based on client need 

Competencies and Best Practice for High Performers:

• Relationship management 
• Leading through ambiguity
• Operational leadership
• Financial Acumen

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.