Senior Capability Manager, Provider Capabilities

UnitedHealth Group; Eden Prairie (MN); Hybrid; USD 113,000 - 193,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase program

401k contribution

Job summary

UnitedHealth Group seeks a Senior Capability Manager to define and lead the strategy for Optum Rx clinical data exchange capabilities. You will align business sponsors, secure funding, and drive cross-functional initiatives with vendors and internal teams to ensure data availability and usable interoperability.

You will manage complex programs, translate requirements into actionable plans, and monitor outcomes while collaborating with architecture, privacy, and governance groups to maintain

Qualifications

• 5+ years of healthcare industry leadership on complex cross-functional initiatives.
• Experience with healthcare interoperability and clinical data exchange (FHIR, NCPDP, HL7).
• Ability to translate business needs into executable capability plans and roadmaps.

Responsibilities

• Own strategy, roadmap, priorities, and evolution of clinical data exchange capabilities.
• Partner with sponsors to prioritize opportunities, justify funding, and ensure enterprise alignment.
• Translate healthcare needs into capability requirements and execution plans.
• Lead cross-functional initiatives across lines of business, partners, and vendors.
• Collaborate with architecture, legal, privacy, security, and data teams on governance.
• Identify data sources and pathways, contracting support, and vendor operations.
• Communicate complex concepts to business, technical, and executive audiences.
• Measure success by data availability, adoption, and business outcomes.

Skills

Healthcare leadership

Interoperability

Clinical data exchange

FHIR

NCPDP

HL7

Vendor management

AI tools

Tools

Aha!

Rally

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 talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Senior Capability Manager, Provider Capabilities enables Optum Rx to acquire and use external clinical data for priority business needs. The role works closely with QHINs, clinical data exchange partners, and vendors to make data available and operationally usable across the organization and to evolve clinical data exchange capabilities as business needs and opportunities change.

This role sets capability strategy, priorities, and roadmap; partners with business sponsors to define use cases, value, funding needs, and outcomes; and leads cross-functional teams and vendors from opportunity identification through implementation and continuous improvement.

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:

• Own the strategy, roadmap, priorities, and ongoing evolution of Optum Rx clinical data exchange capabilities and business use cases
• Partner with business sponsors to prioritize opportunities, refine project scope and value, develop capital funding requests, and secure funding based on feasibility, risk, scalability, data availability, and enterprise alignment
• Translate healthcare business needs into clear capability requirements, data needs, interoperability approaches, success measures, and executable plans
• Lead cross-functional initiatives across Optum Rx lines of business, enterprise partners, technology teams, and external vendors, clarifying ownership, dependencies, decisions, and next steps
• Partner with architecture and engineering on solution design and delivery and with legal, procurement, privacy, security, compliance, and data experts on contracting, governance, regulatory, and data-use considerations
• Identify and manage appropriate networks, vendors, data suppliers, and exchange pathways to acquire data that is available and fit for intended business use cases, including requirements, contracting support, roadmap alignment, implementation, vendor-specific operational processes, and performance
• Communicate complex healthcare interoperability and data concepts in clear business language for technical, non-technical, and executive audiences
• Measure capability success based on data availability and operational usability across intended use cases, and identify opportunities to improve adoption, performance, and business outcomes

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of healthcare industry experience leading complex, cross-functional business, technology, data, or operational initiatives involving enterprise stakeholders and external vendors
• Experience with healthcare interoperability and clinical data exchange, including working knowledge of FHIR, NCPDP, HL7, health information networks, and/or related standards and solutions
• Experience defining capability strategies and roadmaps and translating business needs, value, risk, data, and governance considerations into executable plans and leadership-ready recommendations

Preferred Qualifications:

• Experience with pharmacy, pharmacy benefit management (PBM), prior authorization, medication history, or related provider and pharmacy workflows
• Experience establishing healthcare data partnerships or managing vendors, clinical data suppliers, and/or vendor-specific operational processes
• Experience in Aha! and/or Rally
• Experience using AI tools and resources
• Knowledge of healthcare privacy, security, consent, permitted-use, and data-governance considerations

*All employees working remote 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 $112,700 - $193,200 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.