Payment Integrity Ideation Leader

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:

As an Ideation Leader, you will be responsible for identifying, creating, and developing a portfolio of new medical cost savings opportunities on behalf of our clients. This position will assess new opportunities by leveraging insights from data, dashboards, tools, policies, industry trends, and by soliciting input from a broad network of experts across Optum. This highly trained industry expert will work with internal and external stakeholders to determine opportunities for growth within our core payment integrity businesses and is responsible for savings delivery through deployment.

Primary Responsibilities:

• Industry thought leader on health plan affordability, and medical cost management
• Identify, create, and develop a portfolio of cost savings initiatives that drive specific and measurable results for assigned clients while providing timely and meaningful client updates
• Perform and participate in iterative analytical, experimental, investigative, and other fact-finding work in support of concept development
• Establish strong matrixed relationships with internal stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients
• Influence senior leadership to adopt new ideas, approaches, and/or products
• Recommend changes to current product development procedures based on market research and new trends
• Lead concepts/projects from conceptualization to completion

Required Qualifications:

• Bachelor's degree or equivalent work experience
• General working knowledge of US healthcare system
• Experience in payment integrity or Health Plan affordability more broadly
• Experience using data to inform ideation and strategy towards medical cost savings opportunities
• Highly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areas
• Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
• Solid project management approach with excellent critical thinking and problem solving skills
• Exceptional presentation, communication and negotiation skills\solid computer skills: Excel, Visio, PowerPoint, Tableau

Preferred qualifications

• Degree in health care or medical field
• Coding certification through AAPC or AHIMA
• Experience in claims adjudication or revenue cycle management with specialization in Facility claims
• Experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
• Experience working in a matrix and highly adaptive environment handling tight deadlines
• Proficiency with SQL, SAS and/or other statistical programs

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

Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.

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.