Director, Payer Value Creation & Affordability

Pennsylvania Psychological Association; Eden Prairie (MN); Remote; USD 159,000 - 273,000; Full time

Benefits offered by this job

Comprehensive benefits

Career development opportunities

Remote-friendly policy

Job summary

Optum, a global health services leader, seeks a Director, Behavioral Health Payer Value Creation to lead the payer affordability portfolio. You will partner with clinical, network, finance, analytics, product and client teams to identify opportunities, build credible business cases and deliver measurable value.

The role requires 12+ years in healthcare and a track record of moving initiatives from concept to delivery, with strong executive communication and governance.

Qualifications

• 12+ years of experience in healthcare, managed care, consulting, strategy, operations, affordability or a related field.
• 10+ years leading complex, cross-functional initiatives with accountability for strategy, execution and measurable business outcomes.
• Experience identifying cost or performance improvement opportunities and converting them into executable initiatives.
• Experience working across multiple functions such as clinical, network, payment integrity, finance, analytics, product, operations or client management.
• Proven executive presence, including the ability to communicate complex topics clearly, confidently and concisely to senior audiences.
• Proven track record of moving work from concept to implementation and sustaining accountability through delivery.

Responsibilities

• Own the payer value creation and affordability agenda, including development of priorities, goals, roadmaps and performance expectations aligned to business and customer needs
• Identify and assess emerging cost, utilization, quality and operational trends; translate insights into clear actions that reduce avoidable cost, improve outcomes and strengthen the payer value story
• Build, prioritize and manage a portfolio of payer affordability initiatives across clinical, network, payment integrity, benefits integrity, product and operational levers
• Lead initiatives from opportunity identification through solution design, approval, implementation, adoption, measurement and financial validation, with clear ownership, milestones, risks and dependencies
• Develop rigorous business cases, value models and executive recommendations using data, operational insight and sound assumptions; partner with Finance and analytics teams to validate impact and prevent double counting
• Establish and maintain strong operating disciplines, including portfolio governance, workplans, decision logs, status reporting, issue escalation and executive-ready updates
• Partner across Optum Behavioral Health and the broader enterprise to align stakeholders, resolve barriers and accelerate execution in a complex matrixed environment
• Represent payer affordability strategy, progress, risks and results with senior leaders and internal and external stakeholders through concise, compelling written and verbal communication
• Connect affordability work to quality, access, member experience, provider relationships, regulatory requirements and customer commitments
• Promote innovation and continuous improvement, including the use of advanced analytics, digital tools and AI-enabled capabilities to improve insight, efficiency and decision-making
• Create transparency into portfolio performance, challenge assumptions constructively and ensure teams remain accountable for commitments and measurable outcomes
• Share best practices across lines of business and identify opportunities to scale proven approaches while adapting solutions to payer-specific needs

Skills

Healthcare experience

Managed care

Strategy

Operations

Value creation

Executive communication

Cross-functional leadership

Education

Master's degree in business, healthcare administration, public health or related field

Job description

Optum, a global health services leader, seeks a Director, Behavioral Health Payer Value Creation to lead the payer affordability portfolio. You will partner with clinical, network, finance, analytics, product and client teams to identify opportunities, build credible business cases and deliver measurable value.

The role requires 12+ years in healthcare and a track record of moving initiatives from concept to delivery, with strong executive communication and governance.