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 a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
We are seeking a high-impact Associate Director - Payment Integrity Operations to lead large-scale back-office delivery while owning and driving end-to-end revenue outcomes.
PI Operations Effectiveness is a senior people-leadership role accountable for integrating and accelerating the Payment Integrity Operations Effectiveness agenda across global operations. The role will primarily be responsible to drive Operations Effectiveness by way of driving Operations Rigor and solider operational consistency ensuring zero-surprise execution. This role will additionally manage locally, mentor, develop, and guide PI OOG teams aligned functionally to OI PI Transformation & Capability leadership, while ensuring adherence to local guardrails, policies, and operating rhythms.
This leader should have experience multiple geography (India /PHL).
Primary Responsibilities:
•Provides leadership and direction through managers and senior professional staff to achieve operational, financial, quality, and customer experience objectives
•Work most often impacts a business unit, function, or multiple teams/sites
•Develops and executes strategies for a function or discipline across a business unit or multiple teams/sites
•Leads operational planning, forecasting, resource allocation, and service delivery management to ensure achievement of established performance metrics, SLAs, and business objectives
•Participates in business expansion, service transitions, operational transformation initiatives, and implementation of new capabilities across assigned functions or client portfolios
•Drives continuous improvement efforts through analysis of operational performance, healthcare industry trends, customer requirements, and market opportunities
•Establishes and maintains effective relationships with internal and external stakeholders to support business goals, service excellence, and client satisfaction
•Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements
Additional Scope and Guidelines
•Oversees resolution of complex operational and client escalations, ensuring timely resolution, appropriate documentation, and sustainable corrective actions
•Supports development and execution of strategies that improve healthcare outcomes, operational performance, quality results, and customer experience
•Promotes employee engagement, coaching, talent development, succession planning, and knowledge transfer to strengthen organizational capability
•Monitors regulatory, compliance, and healthcare industry changes to ensure operational readiness and adherence to organizational standards
Required Qualifications:
•Bachelor's Degree or equivalent work experience
•10+ years of experience in healthcare operations, customer service, patient experience, or related leadership roles, with significant experience managing large-scale operations within a BPO/shared services environment
•5+ years of experience managing large-scale back-office operations within US healthcare
•5+ years of people management experience, including managing people managers and leading large operational teams
•5+ years of experience monitoring quantitative and qualitative performance metrics, driving operational improvements, and enhancing customer/patient experience
•Experience leading operational transformation, process improvement, transition, or service delivery initiatives
•Experience working within complex, matrixed, and multi-cultural organizations
•Solid experience in US healthcare operations
•Demonstrated experience leading managers and large operational teams, preferably supporting healthcare operations in a multi-site environment
•Demonstrated experience managing accounts and operations across multiple geographies, preferably including India and the Philippines
•Advanced proficiency in Microsoft Office Suite, particularly PowerPoint and Excel
•Proven ability to manage stakeholder relationships and complex operational escalations
•Proven success leading managers and large operational teams in a multi-site healthcare operations environment
•Demonstrated solid facilitation, organizational development, and stakeholder management skills
•Demonstrated ability to effectively plan, organize, prioritize, and adapt to changing business needs
•Demonstrated solid time and resource management capabilities
