Optum Hiring For Associate Director of Payment Integrity, Business Performance & Transformation – Hybrid at Dublin, County Dublin Full Time

Optum, the fast-growing part of UnitedHealth Group, is a leading information and technology-enabled health services business. Our teams are dedicated to modernizing the health care system and improving the lives of people and communities.

Serving virtually every dimension of the health system, we work with a diverse set of clients across 150 countries – from those who diagnose and treat patients to those who pay for care, deliver health services, and those who supply the cures. Optum maintains operations across North America, South America, Europe, Asia Pacific and the Middle East. Our innovative partnerships provide technology and tools that enable unprecedented collaboration and efficiency. As a result, we can tap into valuable health care data to uncover insights and develop strategies for better care at lower costs.

Here at Optum, part of United Health Group we’ll put you in the driver’s seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It’s the opportunity to do your life’s best work.(sm)

About the role:
At UnitedHealth Group and Optum, we want to make healthcare work better for everyone. This depends on hiring the best and brightest. With a thriving ecosystem of investment and innovation, our business in Ireland is constantly growing to support the healthcare needs of the future.

Our teams are at the forefront of building and adapting the latest technologies to propel healthcare forward in a way that better serves everyone. With our hands at work across all aspects of health, we use the most advanced development tools, AI, data science and innovative approaches to make the healthcare system work better for everyone. Join us and do your life’s best work.

As Associate Director of Payment Integrity, Business Performance & Transformation you will be partnering with key value streams and business units within Optum Payment Integrity Organization. The Associate Director of Payment Integrity, Business Performance & Transformation is essential for supporting the mission affordable health system for all and drive financial savings. Working within the Business Performance Unit, you’ll have the opportunity to work collaboratively within a high-performance team, responsible for driving successful pipeline experience across our value streams and supporting all new projects through the pipeline phases. In addition to having impact on a great team, you’ll also discover the career opportunities you’d expect from an Industry Leader.

Primary Responsibilities:
Responsible for the identification of process improvements to support affordability savings through:

Develop Clinical Business Performance Improvement Strategy across Fraud and abuse value streams to support an ambitious growth target of medical cost savings

Partner with Operations leaders/teams, Analytics and Technology to develop Business Performance Improvement Strategy and create CBA, execution roadmap/resource needs, assess capital needs

Identify, lead specific strategic projects/initiatives while also keeping track of all initiatives within the overall strategy

Analyze clinical data using six sigma techniques and tools to identify potential opportunities

Developing insights and proposals for improved business processes to enable speedy deployment of future projects

Leading and overseeing project charters on agreed initiatives and supporting projects approved

Conduct reviews and joint goal planning sessions with value stream partners on initiatives

Supporting the overall Payment Integrity financial targets

Building, and promoting relationships with business operations leaders to enable growth opportunities.

Collaborating with peer teams (data analysts, project management, feasibility & sizing team, operations leaders)

Participating in operational business initiatives/meetings involving innovations

Provide project direction and performance feedback to leadership throughout the project, as appropriate

Positions in this function are responsible for end-to-end business process activities – creating, controlling and improving business processes

Demonstrate understanding of relevant organizations’ operations, products and applications, strategies, processes, and/or business priorities to build effective solutions

Demonstrate and remain current in understanding of relevant regulations (e.g., CMS guidelines; NDC etc. )

Required Qualifications

Bachelor’s Degree or Undergraduate degree with equivalent experience in Transformation, Change Management, Strategy

Proven track record in developing Transformation Strategy, driving Change Management, identifying and driving Innovation, or related functions

Certified in process improvement and change management programs like Six Sigma, Lean or equivalent degree from reputed university

Strong communication skills and experience communicating at Senior Leadership levels

Preferred Qualifications

Six Sigma Black Belt certified with in-depth understanding of LEAN process

Knowledge of US Healthcare industry, major healthcare entities, Member/Eligibility and claims lifecycle

Experience with Payment Integrity business or Healthcare Financial Services

Knowledge of CPC coding

Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.SM

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. © 2023 Optum Services (Ireland) Limited. All rights reserved.