Director, Business Process

Job title: Director, Business Process

Company: UnitedHealth Group


Job description: 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.In healthcare, evolution doesn’t just happen. It takes innovation, imagination, and a passion for solving problems in new and better ways. And innovation is taking place at a lightning-fast pace every day at Optum.As the fastest growing part of the UnitedHealth Group family of businesses, we’re expanding our team in Ireland and creating excellent opportunities for those who want greater purpose and more impact in their work. We’ll provide the investment, support, and resources to advance your career. You’ll provide the talent, ambition, and drive.This position plays a pivotal role in maintaining operations excellence pertaining to programs that manage, help to qualify, predict, and assess risk of the populations served by our insured business segments and by our clients. Specifically, the Director of Business Process will lead a global team responsible for managing the processes that extract, transform, validate, and finally submit claims, encounter, and supporting clinical information to regulatory agencies who administer Risk Adjustment programs for Medicare Advantage and Commercial clients. This leader will help to develop innovative data management strategies that assist in meeting planned regulatory changes in data submission filtering logic, adapt to future changes that may occur as a result of further health care reform, and validate excellence in data accuracy and quality.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 senior leadership to an operations team around the execution of encounter operations processes
• Lead efforts to enhance high volume data processing to meet regulatory timelines
• Drive efforts to reduce operations cost for Risk Adjustment data submission
• Support internal and external audits, including preparing strategies to meet the needs of Risk Adjustment Data Validation (RADV) testing
• Partner with Technology organization to evaluate platform enhancements, ongoing platform maintenance, and triage technology investments / needs
• Drive continuous improvement of existing processes as well as develop new processes to meet emerging business needs
• Work collaboratively across a broad spectrum of business partners to ensure flawless execution across the full E2E spectrum of encounter operations processes and objectives
• Stay abreast of regulatory changes impacting Risk Adjustment and data submissions / validation processes
• Ensure alignment of IT projects and deliverables with key business metrics (e.g., KPIs)
• Build and maintain productive relationships with key business partners
• Develop team members to drive individual skill enrichment with a focus on the key success factors for encounter operations processes

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:

• Bachelors degree from an accredited college/university
• Proven leadership experience at an upper management level
• Operations Management experience in a high-volume data industry
• Significant experience in leading data management, data quality initiatives
• Experience with data validation / audit processes
• Experience in related industry (healthcare, insurance, finance)

Preferred Qualifications:

• Familiarity with US healthcare system and Risk Adjustment governed by US Legislation and Regulations
• P&L ownership
• Understanding of software development life cycle and Agile framework
• Post-graduate degree in relevant field of study (e.g. – MBA, PhD, MA or MS Finance / Accounting, Computer Science, Engineering)
• Global experience
• Deep knowledge of SQL
• US healthcare knowledge/exposure

Soft Skills:

• Demonstrated people management / team leadership experience
• Confident communication and presentation style
• History of quickly gaining credibility, partnering with business leaders and exhibiting executive presence
• Conceptual, analytical and financial modeling skills as well as critical thinking
• Ability to champion continuous change, consult with versatility, exhibit personal leadership and model a customer orientation
• Ability to effectively drive results in a dynamic, matrixed environment with a high degree of organizational change, growth and ambiguity

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.All telecommuters will be required to adhere to the UnitedHealth Group’s Telecommuter Policy.For more information on our Internal Job Posting Policy, click .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. © 2025 Optum Services (Ireland) Limited. All rights reserved.#RPO

Expected salary:

Location: Dublin

Job date: Tue, 01 Apr 2025 22:28:19 GMT

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