Associate Director, Payment Policy

UnitedHealth Group

  • Dublin
  • Permanent
  • Full-time
  • 9 days ago
Optum is a global organisation 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.In healthcare, evolution doesn't just happen. It takes innovation, imagination, and a passion for solving problems in new and better ways. And innovation is taking place at a lightning-fast pace every day at Optum. As the fastest growing part of the UnitedHealth Group family of businesses, we're expanding our team in Ireland and creating excellent opportunities for those who want greater purpose and more impact in their work. We'll provide the investment, support, and resources to advance your career. You'll provide the talent, ambition, and drive.The purpose of this UHC Payment Policy role is to provide UHC guidance, ensure quality assurance, and coordinate strategic alignment with the Optum Payment Policy Team. Payment Policy is a high value critical function in the Payment Integrity business, responsible for deploying new reimbursement policies and maintaining the integrity of existing ones to ensure accurate claims payment. The Associate Director will create innovative business processes that will ensure concepts are managed from ideation to deployment with aggressive milestones to yield higher outcomes in the quality and value of policies deployed. The Associate Director, Payment Policy will partner closely with UHC stakeholders and Optum Policy teams to champion business growth. This is a key position within a high value, fast-paced and growing function where you will lead significant initiatives that will determine the appropriate payment of claims.This role supports the development and execution of medical cost savings strategies and ensures alignment with enterprise objectives.Schedule: Full-time position with standard working hours of Monday - Friday, 9am - 5pm.Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny office and telecommuting from a home-based office in a hybrid work model.Primary Responsibilities:
  • Partner with Payment Policy leadership to shape and execute strategic initiatives that enhance Payment Policy operations, driving process efficiency and improved outcomes
  • Lead the deployment of key Payment Policy programs, ensuring alignment with broader business growth strategies and operational excellence
  • Manage high-impact tactical projects focused on accelerating concept development, optimizing deployment timelines, and ensuring post-implementation performance meets or exceeds savings targets
  • Apply healthcare coding expertise to inform oversight of concept development and ensure compliance with regulatory and coding standards
  • Use dynamic/agile/flexible approach to prioritizing projects and resources to hit organizational strategic aims
  • Identify and champion opportunities to streamline operations through automation, advanced technologies, and process optimization. Develop compelling business cases and secure stakeholder alignment for implementation
  • Leverage healthcare coding expertise to inform concept development, ensuring maximum value realization while maintaining compliance with regulatory requirements and correct coding standards
  • Utilize data visualization tools to create intuitive dashboards, process flows, and performance metrics that support decision-making and transparency
  • Develop and maintain robust management reporting frameworks to track savings delivery, proactively identify off-target performance, conduct root cause analysis, and monitor the financial and operational impact of deployed policies
  • Cultivate strong partnerships across Optum and UHC to ensure program objectives are met and enterprise-wide value is realized
  • Provide strategic guidance and operational support to internal and external stakeholders to facilitate seamless program execution
  • Actively contribute to the Payment Integrity transformation agenda, fostering cross-functional collaboration and driving enterprise-level impact
  • Influence senior leadership and key business partners to adopt innovative approaches, policies, and solutions that advance Payment Policy objectives
You will be rewarded and recognised 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 providing development for other roles you may be interested in.Required Qualifications:Bachelor's Degree (or higher) in applicable area of expertise or equivalent experienceExperience with claim-related initiatives involving complex regulatory requirements and clinical collaborationExperience in data analysis and ability to convey complex or technical information understandablyAbility to comprehend and research CMS regulations and processing requirements for Medicare, Medicaid, and Dual SNP populationsIntermediate level of proficiency with MS Office, Microsoft Project, and PowerPointPreferred Qualifications:Certified Professional Coder (CPC) or equivalent coding certification or backgroundAnalytic skills to assess program opportunities, evaluate success/savings, and assess business risk impactComprehension of contractual languageExperience and understanding of the US Healthcare Industry, major healthcare entities, and claim lifecycleProven track record in delivering business metrics improvement results, including medical cost savingsSoft Skills:Communication skills with the ability to present information in various formats to all levels of stakeholdersAbility to manage and coordinate divergent business priorities with lean resourcesPlease 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.All telecommuters will be required to adhere to the UnitedHealth Group's Telecommuter Policy.For more information on our Internal Job Posting Policy, click .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 marginalised 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.#RPO

UnitedHealth Group