Director, Payment 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, with an analytical and growth mindset to comprehend current and emerging trends of claim leakage through the Payment Integrity value chain. Experience required will be a high level of systems thinking leading to the development of innovative solutions and a proven ability to identify and map new initiatives to resolve claim leakage. The Successful candidate will provide ideation & growth leadership specifically focused on the identification and resolution of Payment Integrity leakage through data, analytic and operational solutions. Work with data, analytic and other enablement teams to progress a clear operations vision pertaining to claim leakage. In parallel, partner with business functions and leakage detection SMEs to progress a portfolio of initiatives to achieve in year incremental medical cost savings and positive IOI outcomes. As part of core responsibilities, seek to develop, incubate and transition leakage detection capabilities toward fully supported production environments, processes and 

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:

•    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.
•    Taking a client agnostic lens, 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. 
•    Lead and agree operational development requirements, resources (data, etc) and ‘business requirement documents’ in partnership with product, engineering and value streams as part of the ideation & growth strategy.
•    Partner with data & analytic and engineering teams to ensure enabling capabilities are fully aligned e.g. data acquisition / enablement, analytic modernization and client agnostic leakage detection solutions.
•    Support the design and functioning of competitive intelligence processes to enable ideation lead generation and external / internal content opportunities.  
•    Establish data and business controls to ensure growth opportunities are sourced and vetted appropriately prior to development and/or deployment.

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 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. 

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. © 2024 Optum Services (Ireland) Limited. All rights reserved.