Remote Operations Lead, Commercial Data Mining

Optum; Plymouth (MN); Hybrid; USD 90,000 - 130,000; Full time

Job summary

OptumInsight is seeking an Operations Manager for the Commercial Data Mining team to drive ideation, establish operational standards, and optimize resource use. You will automate processes, improve efficiency, and build strong client relationships to support internal and external financial goals.

You’ll have the flexibility to work remotely from anywhere in the U.S., with Minneapolis/DC area staff needing in-office four days per week, and you will guide data workflows, audits, and reporting to

Qualifications

• 4+ years in healthcare, health insurance, payer operations, claims, payment integrity, or related experience
• 2+ years of experience with healthcare coding guidelines, reimbursement policies, and payment methodologies
• 2+ years of experience communicating with business stakeholders, clients, or leadership
• Proven understanding of healthcare claim adjudication and payer workflows
• Demonstrated understanding of EDI data, including 837 claim submission and 835 payment/remittance data
• Demonstrated ability to work independently and manage multiple priorities through completion

Responsibilities

• Ensure timely data acquisition and accuracy
• Maintain ideation pipeline
• Prioritize and manage audit production efficiency
• Drive timely recoveries
• Assist in strategic planning and budgeting
• Effectively communicate with, manage, and develop staff
• Provide reporting and attend meetings with internal and external stakeholders
• Support internal quality assurance efforts

Skills

Healthcare operations

Stakeholder communication

Process improvement

Project management

Job description

OptumInsight is seeking an Operations Manager for the Commercial Data Mining team to drive ideation, establish operational standards, and optimize resource use. You will automate processes, improve efficiency, and build strong client relationships to support internal and external financial goals.

You’ll have the flexibility to work remotely from anywhere in the U.S., with Minneapolis/DC area staff needing in-office four days per week, and you will guide data workflows, audits, and reporting to