Remote Director, Benefits Strategy & Governance

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 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.