Director of Payment Integrity, Business Performance and Process Improvement

Job title: Director of Payment Integrity, Business Performance and Process Improvement

Company: UnitedHealth Group


Job description: Optum is a global organization 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 roleWe have a key leadership role open for the Director Business Performance & Process Improvement, Payment Integrity based in Ireland.This is a key management position, based in Ireland, within a high value, fast paced and growing function and will lead significant change and transformation within the operations reporting to Senior Director / VP. The successful candidate is accountable directly and indirectly through a matrix team as defined here.Responsibilities:

• Develop Non-Clinical Business Process Improvement & Transformation Strategy across a span of value streams to support an ambitious growth target across cost efficiency and medical cost savings
• Partner with Operations leaders/teams, Analytics, R&D(Research & Development), Technology to develop Business Process Improvement & Transformation Strategy and to 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
• Ensure operational performance improvements are tracked accurately, by establishing and automating statistical control models for value streams, utilizing internal tools and processes (e.g., dashboards; scorecards; reports) to update relevant stakeholders on the status of work projects, with operational improvements and root cause actions taken quickly to remedy under performance, develop corrective action plans to address and resolve relevant stakeholders’ concerns or issues regarding program performance as required
• Monitor and propose changes to performance metrics in partnership with finance, Analytics, workforce management / industrial engineering and ensuring benefits are accounted in P&L and productivity reports
• Provide guidance and assistance to internal and external (client) partners to ensure programs and strategies are implemented effectively and value realized
• Collaborate with stakeholders, ability to influence without authority to gain support and buy-in for proposed business process solutions and adherence to team requirements
• Communicate with Leadership/Senior Leadership about progress, challenges and actions required to remove hurdles

Required Qualifications:

• Bachelor’s Degree or Undergraduate degree with equivalent experience in Transformation, Change Management, Strategy
• Communication skills and experience communicating at Senior Leadership levels
• Proven track record in developing Transformation Strategy, driving Change Management, identifying and driving Innovation, or related functions
• Proven track record in managing large scale complex programs within a matrix environment
• Trained in process improvement and change management programs like Six Sigma, Lean or equivalent degree from reputed university

Preferred Qualifications:

• Masters Degree or Business Degree in Technology / Digital / Change Management
• 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
• Identifying and leading growth activities

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.SMAt 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 marginalized 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.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. © 2025 Optum Services (Ireland) Limited. All rights reserved.

Expected salary:

Location: Dublin

Job date: Fri, 04 Apr 2025 22:35:15 GMT

To help us track our recruitment effort, please indicate in your email/cover letter where (jobsnear.pro) you saw this job posting.Thanks&Good Luck