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.
The Senior Director - 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 more solid 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.
Purpose and Business Need
•Provide one accountable leader to drive operational rigor/Zero surprise operations, Ops reporting coordination with BAR (Reporting) team, end to end integrate Ops POD SME buildout (FDOS - Forward Deployment Ops SMEs), OOG Operations capability standardization, OOG transformation solutions implementation & execution, partner on Operations growth optimization
•Reduce risk of fragmented execution, inconsistent standards, slower decisions, and limited visibility to value delivery
•Strengthen local leadership for PI OOG resources that are functionally aligned to OI PI Transformation & Capability leadership while operating within local guardrails and policies
•Drive and support value realization across Operations cost efficiency, Operations medical cost savings, transformation solutions implementation within Operations, Operations SLA performance, Operations quality outcomes, and operating predictability
Primary Responsibilities:
•Operational Excellence, Rigor & Automated Reports Coordination - Partner with Operations Functional leaders to Design, implement, and continuously refine governance frameworks, operating cadences, RAG visibility, performance routines, and integrated risk review mechanisms
•Partner with the automated reports/Initiatives/Teams to strengthen visibility to SLAs, quality, inventory, capacity, dependencies, and emerging execution risks
•Partner with Operations Functional leaders to identify underperformance drivers, mobilize corrective actions, and ensure cross-functional closure discipline
•Partner with Operations Functional leaders on accuracy of Workforce and Capacity planning
•Strategic Leadership & Business Ownership - Execute the operating strategy for PI Operations Transformation, Optimization & Rigor in alignment with OI Transformation and Capability priorities
•Lead through multiple layers and teams, including direct and matrixed resources, with clear decision rights, governance routines, and escalation pathways
•Own the integrated implementation & execution model for transformation deployment, capability standardization, operational reporting, and growth optimization across global locations
•Transformation Deployment & Capability Standardization - Translate new PI transformation ideas, automation opportunities, analytics outputs, and product / technology capabilities into deployable operating models working with PI OOG teams
•Build scalable playbooks, implementation approaches, and repeatable capability standards
•Ensure PI OOG teams have clear expectations, training, feedback loops, and readiness support for transformation adoption
•Growth Optimization & Business Value Delivery - Partner with Functional Leaders and Ideation & Growth teams to operationalize new opportunities that improve payment accuracy
•Support cost efficiency and transformation-solution penetration through disciplined operating execution and adoption management
•Track and communicate value realization, risks, blockers, and decision are needed to executive stakeholders
•People Leadership & Talent of the Future - Lead, coach, and develop managers, transformation resources, Super SMEs, and implementation analysts to build a future-ready operations talent pipeline
•Promote accountability, ethical conduct, inclusion, engagement, and high-performance team behaviors across distributed operations
•Partner with OI Transformation to shape AI / automation-aligned operations talent capabilities and workforce readiness
•Stakeholder Partnership & Executive Communication - Serve as a senior point of integration across PI Global Operations, OI PI Transformation & Capability leadership
•Provide concise executive updates on progress, risks, value delivery, capability gaps, and decision asks
•Represent operational realities in transformation forums and ensure solutions are practical, scalable, and locally executable
•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
Success Measures / Value Thesis:
•Operations SLA and quality performance discipline, including consistent operational routines that support SLA >=goal% and Quality >=goal% where applicable to the portfolio
•Zero-surprise operations enabled by proactive risk visibility, governance cadence, Command Center coordination, and timely escalation closure.
•Ops Cost efficiency support and contribution through disciplined execution of transformation and operational productivity opportunities
•Ops Growth Optimization/Savings Per Claim in partnership with Operations Functional Leaders, Business Stakeholders
•Operations Transformation solution penetration through forward deployment, adoption readiness, and operating-model standardization
•Clarity and alignment across decision rights, roles, scopes, cadences, and cross-functional communication patterns
Required Qualifications:
•Graduate / Postgraduate degree from a recognized university
•15+ years of progressive leadership experience, including 8- 10+ years leading large-scale healthcare operations, Payment Integrity, Claims, Quality, Clinical Operations, transformation, or related domains
•Solid operating-rigor mindset with experience managing SLAs, quality, staffing, budgets, governance cadences, execution risks, and executive reporting
•Solid people leader with demonstrated capability in mentoring, developing leadership pipelines, building engagement, and managing teams through business change cycles
•Proven experience leading large-scale operational transformation, automation adoption, process standardization, performance turnaround, and cross-functional change execution
•Demonstrated ability to lead through influence across Matrix organization structure
•Ability to operate within flexible shift hours support Ireland, U.S. and India business hours and travel as required
Leadership Competencies:
•Strategic integrator: connects multi model/matrix organization
•Execution disciplinarian: establishes rhythm, ownership, decision rights, and follow-through without creating unnecessary bureaucracy
•Change leader: translates complex ideas into operationally consumable playbooks, routines, and expectations
•Talent builder: creates a future-ready operations talent pipeline aligned with AI, automation, and capability-led delivery models
•Executive communicator: communicates progress, risks, value, and decisions in a concise, fact-based, business-outcome-oriented manner
