Director, Payer Systems and Applications Technology Consulting - Remote

UnitedHealth Group; Eden Prairie (MN); Hybride; USD 135 000 - 231 000; Plein temps

Résumé du poste

Optum Insight, part of UnitedHealth Group, seeks a senior payer-operations leader to drive complex platform transformations, AI-enabled initiatives and cross-functional delivery across payer platforms. Remote work is allowed nationwide with in-office four days weekly in Minneapolis or Washington, D.C.

area requirements for certain roles may apply. You will own end-to-end delivery, governance and stakeholder alignment across diverse teams, ensuring outcomes, quality and client satisfaction in

Qualifications

• 10+ years of healthcare experience across payer operations and consulting.
• 5+ years in healthcare technology consulting for payers.
• 5+ years leading programs or teams with client-facing accountability.
• 5+ years with major payer platforms (TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems).
• 1+ year evaluating AI opportunities in healthcare or regulated industries.

Responsabilités

• Act as trusted advisor across client business and technology orgs, building durable relationships with executives and delivery partners.
• Assess current-state processes, applications, architecture, data, integration patterns and operating models to identify transformation priorities.
• Formulate technical solution architectures for payer platform implementations, migrations, modernization, optimization and integration.
• Lead or oversee implementations and modernization programs involving core administrative payer platforms such as TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems or comparable platforms.
• Own end-to-end delivery for complex payer system transformation programs with outcomes, quality and client experience accountability.
• Establish delivery governance, integrated plans, decision rights, architecture oversight, and executive reporting across workstreams and vendors.
• Manage scope, budget, schedule, resources, risks and changes; address delivery variance and facilitate fact-based decisions.
• Lead multidisciplinary teams including architects, analysts, engineers and change leaders, applying Agile or hybrid delivery methods.
• Identify and prioritize AI opportunities across claims, enrollment, customer service and provider data.
• Help clients develop AI-enabled transformation roadmaps and measurable adoption outcomes.
• Participate in pursuits, solutioning, and proposals; expand accounts by mapping client needs to capabilities.
• Contribute to sales objectives, including generating new account growth and revenue responsibility.
• Advance service offerings and thought leadership related to payer platform transformation and AI-enabled operations.
• Lead creation and quality review of client-facing deliverables and executive materials.

Connaissances

Healthcare experience

Healthcare technology consulting

Program leadership

Payer platform knowledge

AI opportunities evaluation

Outils

TriZetto Facets

HealthRules Payer

QNXT

Epic Tapestry

ikaSystems

Description du poste

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. 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:

• Act as a trusted advisor across client business and technology organizations, building durable relationships with executives, platform owners, operational leaders and delivery partners
• Assess current-state business processes, applications, architecture, data, integration patterns and operating models to identify transformation priorities and constraints
• Formulate technical solution architectures for payer platform implementation, migration, modernization, optimization and application integration initiatives
• Build consensus among client stakeholders and translate complex technical choices into clear business implications, decisions and implementation roadmap
• Lead or oversee implementations and modernization programs involving core administrative payer platforms such as TriZetto Facets, HealthRules Payer, QNXT, Epic, Tapestry, ikaSystems or comparable platforms
• Guide work across claims, enrollment, billing, benefits, provider, pricing, customer service, finance and related payer capabilities, including integrations with digital, data, clinical and enterprise applications
• Own end-to-end technical delivery for complex payer system and application transformation programs, with accountability for outcomes, quality and client experience
• Establish delivery governance, integrated plans, decision rights, architecture oversight, quality controls and transparent executive reporting across multiple workstreams and vendors
• Manage scope, budget, schedule, resources, dependencies, risks, issues and changes; proactively address delivery variance and facilitate fact-based client decisions
• Serve as the senior escalation point for delivery teams, remove blockers and lead recovery planning when commitments, quality or outcomes are at risk
• Lead multidisciplinary teams that may include solution architects, product and business analysts, engineers, configuration specialists, data and integration teams, testers, program managers and change leaders
• Apply Agile, hybrid or structured delivery methods appropriate to the client environment, including capability planning, release planning and Program Increment planning where applicable
• Demonstrate working knowledge of AI, generative AI, intelligent automation, machine learning and analytics concepts relevant to healthcare payer operations and technology delivery
• Identify and prioritize practical AI opportunities across claims, benefits, provider data, enrollment, customer service, testing, knowledge management, configuration analysis and program delivery
• Help clients develop AI-enabled transformation roadmaps, value hypotheses, pilot plans, operating-model changes and measurable adoption outcomes
• Participate in pursuits, solutioning, proposal development, presentations and negotiations; expand existing accounts by connecting client needs to differentiated advisory and technology capabilities
• Contribute to annual sales objectives, including demonstrated success generating at least $1.5M in new sales or comparable account growth responsibility
• Advance service offerings, delivery methods, reusable assets, market perspectives and thought leadership related to payer platform transformation and AI-enabled operations
• Lead the creation and quality review of compelling client-facing deliverables, executive narratives, recommendations and decision materials

Required Qualifications:

• 10+ years of relevant healthcare experience in health insurance, payer operations, healthcare technology or management consulting
• 5+ years of healthcare technology consulting experience supporting payer organizations
• 5+ years of program, project, engagement or team leadership with direct client-facing accountability
• 5+ years of experience with one major payer platform, such as TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems or a comparable core administrative system
• 1+ years of evaluating AI opportunities and risk for automation use cases, delivery considerations, value measurement and responsible adoption in healthcare or other regulated industries

Preferred Qualifications:

• Agile, SAFe, program management, cloud, architecture, payer platform or AI-related certifications
• Leadership experience across more than one core administrative payer platform or in a multi-platform payer environment
• Experience leading cloud migration, legacy modernization, and/or platform consolidation programs for payers
• Experience mentoring managers and consultants and leading geographically distributed, cross-functional teams
• Experience creating service offerings, accelerators, intellectual capital or external thought leadership

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.