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:

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.
The Coordination of Benefits (COB) and Subrogation Director is responsible for the overall business model and strategy for the UHC Payment Integrity Coordination of Benefits and Subrogation business function.
Primary accountabilities include accountability for the COB and Subrogation business plan, operations performance, strategic business plan development and execution a high dollar affordability growth agenda and delivering on a positive Constituent Experience.
This leader will need to possess strategic vision, relationship management, superior analytic and communication skills along with a proven track record of delivering results. Working collaboratively with in our largely matrix organization, breaking down organization barriers and building alliances will be key to the successful realization of our growth and transformation initiatives.
The individual will also work closely with all Payment Integrity Business Owners including Fraud & Abuse, Waste & Error, High Dollar Claim, Reimbursement Policy, SAM Edit, Data Mining, and Recovery across all Lines of Business. As well as have oversight responsibilities of delegated entities that have shared accountability for performance delivery.

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 and telecommuting from a home-based office in a hybrid work model.

Primary Responsibilities:

• Provide strategic leadership and oversight of UHC Payment Integrity COB and Subrogation with accountability for Operations performance, Constituent experience and for achieving Medical Cost Savings delivery targets
• Works closely with UHC leadership to identify and develop affordability opportunities with a clear understanding of key growth initiatives and potential solutions minimizing overlap while reducing costs across the enterprise
• Partners across a highly matrixed organizations (e.g., concept research, data analytics, product, data enablement, technology, strategic planning, finance, solution architecture, and automation) to ensure planned SG&A, Medical Cost savings and affordability results are delivered
• Play a primary leadership role to drive continued NPS performance improvement while executing on a portfolio of improvement initiatives
• Proactively engage with business transformation teams to drive innovation to maximize opportunities and deliver incremental Medical Cost Savings / affordability
• Establish data and business controls to ensure the delivery of high-risk operational and affordability growth targets
• Collaborate with business stakeholders as needed across UHG on outcomes and ensure communication strategies are aligned across each of the supporting Shared Services infrastructure so Providers have consistency in messaging.
• Develop cadence for all management reporting including root cause and trending to ensure operational and affordability savings meet the needs of the business. Recognizes internal impact(s) of outcomes and reaction of constituents and provides messaging to upper management based upon identified issues
• Collaborates with other PI Ops Oversight leads, US-based team members, UHC PI financial Leadership and Optum PI leadership to align on overall KPI/MBO’s and deliverables.

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:

• Degree in business and/or healthcare related fields – MBA a plus
• Proven ability to develop strategic plans that ensure long-term organizational success
• Proven leadership with the ability to build relationships/collaborate and influence all levels of leadership across UHG: strong conflict resolution skill sets.
• Highly skilled at effectively managing divergent business priorities with lean resources.
• Previous experience in leading functional teams, as well as navigating complex stakeholder relationships in a matrix environment with politically sensitive concerns.
• Strong communication skill sets, with the ability to present information in a variety of different formats to all levels of stakeholders.
• Strong analytical skills, with the ability to articulate and define outcome measures that capture key affordability metrics.
• Transactional (claims) related experience that involves regulatory complexity preferred
• Previous COB experience preferred

Preferred Qualifications:

• Highly collaborative individual with ability to influence others and build strong stakeholder relationships internally, as well as externally.
• Proven history of success in developing collaborative and productive working relationships across the provider network environment.
• Superior strategic planning and strong problem-solving skills that enable quick identification and efficient resolution of issues.
• Keen understanding of the financial and operations levers of the business that drive profitability and growth.
• Empowers and motivates others.
• Serves as a strong coach and fosters career development of others
• Transactional (claims) related experience that involves regulatory complexity preferred
• Previous COB experience preferred

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.

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.

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