Director, P ayment Integrity Non-Clinical Vendor Insourcing Leader- Dublin or Letterkenny / Hybrid Optum is a global organisation 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.
About the Role: As a Fortune 5 business, we're one of the world's leading healthcare companies.
There are no limits here on the resources you'll have or the challenges you'll encounter.
We have been supporting global healthcare systems from Ireland and the UK for more than 20 years, building a dynamic and diverse team of more than 2,100 talented individuals.
With a continued record of growth and stability, we're on the constant lookout for fresh talent to join our expanding teams.
Non-Clinical Operations Payment Integrity within Optum Payer Operations is responsible for driving the development and execution of medical cost savings growth for UnitedHealthcare and Commercial client health plans by ensuring payment accuracy to support the enterprise objectives.
The Non-Clinical Operations business drives significant medical costs savings from claims received by health care providers through all lines of business / Health plans in parallel to other operations within Payer Payment Integrity, technology, analytic & enablement teams.
This opportunity is based in Ireland.
The successful candidate will be an accomplished innovator and communicator able to understand the current and emerging trends of medical spend of our customers, have ability to map these trends to Optum/vendor opportunities and capitalize on this insight for increased market share for the PI business.
The successful candidate will be responsible for leading solution paths to support process improvements and transformation change with a specific focus to improve claims audit outcomes within our Operations that serve the United Healthcare business, and partnering with R&D / analytics, audit operations, automation/digital teams with existing or future solutions (including new technology assets) resulting in revenue and market share growth.
This is a key management position within a high value, fast paced and growing function within the Non -Clinical Operations and will work with technology partners and other enablement teams to progress a clear strategic insourcing vision with a high level of operational effectiveness.
The successful candidate is to provide leadership specifically focused on preemptive and responsive solutions to vendor risk and identification profiles.
Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny offices and telecommuting from a home-based office in a hybrid work model.
Primary Responsibilities: • Accountable for developing and steering strategy and acts as a thought leader 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 / industrial engineering and value streams as part of the insourcing strategy • leading large-scale data, technology and application change within a matrix environment with a focus on operational solutions and benefit realization 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 / teams MBO's • Executive level engagement and stakeholder management.
You will be rewarded and recognised 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 providing development for other roles you may be interested in.
Required Qualifications: • Bachelor's degree or commiserate 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 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 though a technology change cycle All telecommuters will be required to adhere to the UnitedHealth Group's Telecommuter Policy.
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 marginalised 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.
Optum is a drug-free workplace.
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