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 diversity and inclusion, 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 to start Caring. Connecting. Growing together.
Payment Integrity Exploratory Operations within Optum Payer Operations is responsible for driving the identification, validation, and execution of new medical cost savings opportunities for UnitedHealthcare and client health plans. This team plays a critical role in advancing enterprise affordability goals by ensuring payment accuracy and enabling sustainable growth across the Payment Integrity product suite.
This role is focused on leading the exploratory ideation function-overseeing a globally distributed team responsible for identifying new savings opportunities, coordinating validation efforts, and supporting financial reporting across the exploratory portfolio. The leader will partner closely with Product, Operations, and Enablement teams to translate ideas into measurable outcomes and ensure strong alignment to enterprise priorities.
The successful candidate will bring strong operational leadership, a deep understanding of Payment Integrity, and a passion for developing high-performing teams in a fast-paced, evolving environment. This role carries direct accountability for delivering against defined medical cost savings targets through the effective management of the exploratory ideation pipeline.
Primary Responsibilities:
- Lead and develop a global team focused on exploratory ideation, ensuring strong performance, engagement, and alignment to business priorities
- Drive the identification and advancement of new medical cost savings opportunities across the Payment Integrity product suite
- Own delivery against assigned medical cost savings targets, ensuring the exploratory ideation pipeline converts to validated and realized savings outcomes aligned to enterprise goals
- Oversee the intake, prioritization, and tracking of ideation efforts, ensuring clear visibility into pipeline progress and outcomes
- Partner with Product, Operations, and solution teams to facilitate the validation and deployment of new concepts into production
- Establish disciplined processes and governance to ensure consistency, scalability, and accountability across exploratory initiatives
- Own coordination of financial reporting for exploratory ideation, consolidating inputs across teams to ensure accurate and timely reporting to leadership
- Monitor performance against key business metrics, including savings generation, concept conversion, and productivity targets
- Support forecasting and monthly reconciliation processes related to exploratory savings and return on investment
- Act as a key liaison across teams to align priorities, remove barriers, and drive execution against strategic growth objectives
- Foster a culture of accountability, continuous improvement, and strong team collaboration across a globally distributed workforce
- Communicate progress, risks, and opportunities clearly to senior leadership in a structured and actionable manner
Required Qualifications:
- Bachelor's degree or equivalent experience
- 8+ years of experience leading operational teams within healthcare, Payment Integrity, or a related function
- In-depth knowledge of the U.S. healthcare industry, including claims lifecycle and Payment Integrity operations
- Demonstrated experience managing globally distributed or matrixed teams
- Solid understanding of medical cost savings drivers, claims accuracy, and leakage identification processes
- Proven ability to operationalize strategy into structured processes and measurable outcomes
- Experience managing financial performance metrics, reporting, and forecasting within a business function
- Solid problem-solving skills with the ability to navigate complex, cross-functional environments
- Excellent leadership, communication, and stakeholder management capabilities
- Ability to manage multiple priorities and drive execution in a fast-paced, evolving environment
Preferred Qualifications:
- Experience within Payment Integrity exploratory, ideation, or growth-focused functions
- Background in business process improvement, governance, and operational scaling
- Familiarity with financial reporting and performance management in a large enterprise environment
- Experience supporting large-scale transformation or growth initiatives within healthcare operations
- Demonstrated success in developing and mentoring team members into future leadership roles
Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2025 Optum Services (Ireland) Limited. All rights reserved.
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Skills Required
- Bachelor's degree or equivalent experience
- 8+ years of experience leading operational teams within healthcare, Payment Integrity, or a related function
- In-depth knowledge of the U.S. healthcare industry, including claims lifecycle and Payment Integrity operations
- Demonstrated experience managing globally distributed or matrixed teams
- Solid understanding of medical cost savings drivers, claims accuracy, and leakage identification processes
- Proven ability to operationalize strategy into structured processes and measurable outcomes
- Experience managing financial performance metrics, reporting, and forecasting within a business function
- Solid problem-solving skills with the ability to navigate complex, cross-functional environments
- Excellent leadership, communication, and stakeholder management capabilities
- Ability to manage multiple priorities and drive execution in a fast-paced, evolving environment
- Experience within Payment Integrity exploratory, ideation, or growth-focused functions
- Background in business process improvement, governance, and operational scaling
- Familiarity with financial reporting and performance management in a large enterprise environment
- Experience supporting large-scale transformation or growth initiatives within healthcare operations
- Demonstrated success in developing and mentoring team members into future leadership roles
Optum Compensation & Benefits Highlights
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Leave & Time Off Breadth — PTO accrues each pay period with eight paid U.S. holidays plus a floating holiday, and generous time away is consistently emphasized. This breadth supports planned and unplanned time off beyond standard vacation days.
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Parental & Family Support — Six weeks of paid parental leave, up to two weeks of paid caregiver leave, Bright Horizons back‑up care, and adoption assistance signal strong family-oriented support. EAP access with counseling sessions further extends help to employees and their households.
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Wellbeing & Lifestyle Benefits — Company‑paid short‑ and long‑term disability, Calm app membership, tuition reimbursement, commuter and FSA accounts, and broad employee discounts expand everyday wellbeing resources. Free or low‑cost virtual visits complement these lifestyle supports.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.