Director, Benefits Planning and Strategy - Remote

Optum; Draper (UT); Remote; USD 135,000 - 231,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive & recognition programs

Equity stock purchase

401k contribution

Job summary

Optum is a global health tech and services company seeking a seasoned leader to govern benefit administration and regulatory strategy. You will translate CMS guidance into actionable guidance, oversee Approved Product governance, and support cross-functional readiness cycles.

You will collaborate with Sales, Product, and Operations while guiding AI-enabled improvements that drive scalable, compliant outcomes.

Qualifications

• 8+ years of experience in Medicare Advantage, Medicaid, benefits administration, and/or healthcare strategy.
• Experience developing governance and operational processes in a healthcare or financial services environment.
• Understanding of the three lines of defense and control development.
• Demonstrated expertise interpreting CMS guidance and translating regulatory requirements into business strategy, governance, and operational execution.
• Proven ability to influence senior leadership and drive organizational alignment around complex business decisions.
• Proven comfortable using AI tools and technologies to enhance productivity and decision-making.

Responsibilities

• Serve as the company's thought leader and SME on Directed Spend benefit administration, CMS guidance, and evolving regulatory requirements.
• Translate CMS regulations and policy changes into actionable guidance and operational guardrails.
• Own enterprise governance for Approved Product (APL) strategy, administration, and execution.
• Support annual sales and 1/1 readiness cycles as SME for Sales, Account Management, Product, Operations, and control functions.
• Ensure alignment between approved benefit designs, client needs, product capabilities, and contractual obligations as Directed Spend expands.
• Influence senior leaders to adopt solutions balancing customer outcomes with regulatory considerations.
• Lead or contribute to embedding AI solutions to modernize processes and scale the business.

Skills

Medicare Advantage

Healthcare strategy

Regulatory guidance

Executive communication

AI tools

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Join us to startCaring. Connecting. Growing together.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities

• Benefit Governance & Regulatory Strategy
  • Serve as the company's thought leader and subject matter expert on Directed Spend benefit administration, CMS guidance, and evolving regulatory requirements
  • Translate highly complex CMS regulations, compliance requirements, and policy changes into actionable business guidance, decision frameworks, and operational guardrails
• Own enterprise governance for Approved Product (APL) strategy, administration, and execution. Develop APL governance playbook, capabilities and controls to oversee and execute benefits that are delivered accurately, consistently, and in compliance with contractual and regulatory obligations
• Support the annual sales and 1/1 readiness cycles as the SME partner for Sales, Account Management, Product, Operations, and control functions by ensuring approved product lists are updated and answering support questions to clarify rationale for product coverage
• As Directed Spend benefit programs expand to new clients and use cases, ensure alignment between approved benefit designs, client needs, product capabilities, operational processes, and internal / external contractual commitments
• Influence senior leaders and stakeholders to adopt solutions that strengthen customer outcomes while balancing operational and regulatory considerations
• Lead and/or contribute to efforts to embed AI solutions into processes, modernize operating models, and improve scalability as the business grows

Required Qualifications

• 8+ years of experience in Medicare Advantage, Medicaid, benefits administration, and/or healthcare strategy
• Experience developing governance and operational processes in a healthcare or financial services environment
• Understanding of the three lines of defense and control development
• Demonstrated expertise interpreting CMS guidance and translating regulatory requirements into business strategy, governance, and operational execution
• Proven ability to influence senior leadership and drive organizational alignment around complex business decisions
• Proven solid executive presence with the ability to translate highly complex concepts for diverse audiences
• Demonstrated success solving ambiguous, enterprise-level business challenges
• Proven comfortable using AI tools and technologies to enhance productivity and decision-making

Preferred Qualifications

• Experience with Medicare Advantage supplemental benefits, Directed Spend programs, or consumer healthcare financial products
• Knowledge of CMS bid cycles, APL development, benefit administration governance, and regulatory compliance processes
• Proven track record of developing innovative solutions in response to emerging healthcare, regulatory, or customer trends
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay and Benefits

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.