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.
The Senior Director of Performance Optimization is part of the Optum Health National Office of Revenue Cycle Management and will serve as one of the key leaders that will support and oversee our care delivery organization (CDO) relationships related to revenue cycle performance and vendor management. The Senior Director of Optimization and Site Engagement will have to be adept at defining and implementing high value add projects and process improvement opportunities for the business at a senior leadership level. A top candidate will be a proven resource in defining strategy, measuring current state, analyzing progress to goals, improving based on project progress, and controlling performance on a go-forward basis for many projects under multiple deadlines. This role requires extensive collaboration with multiple lines of business and stakeholders, including third party vendors. This leader will work in partnership with our site engagement partners to ensure that we have visibility into revenue cycle performance. This role will require up to 70% travel.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
- Must be able to provide revenue cycle subject matter expertise to our physician practices and articulate the revenue cycle process from start to finish, including how each lane depends on the other for accuracy in data and claims processing
- Measure and evaluate RCM KPIs, and if metrics are not meeting enterprise expectations, travel on site to our Care Delivery Organizations (CDOs) to help with revenue cycle training, process reviews, metrics education, and more
- Implement a supplier performance management program with 3rd party vendors who can assist in all aspects of revenue cycle functions. This includes executing an Request for Proposal (RFP) process to identify preferred suppliers for our CDOs
- Act as the key liaison to our offshore vendor partners and create a structured monthly business review process with these suppliers to hold them accountable as well as manage offshore resources for top tier performance
- Track, analyze, and report on key revenue cycle metrics (e.g., MNCR (Managed Net Collection Ratio), debit days in accounts receivable, bad debt, etc.) during monthly and quarterly business reviews with CDOs using our centralized business office teammates. Use data to identify trends, inefficiencies, and areas for improvement, and step in to train and educate if gaps in performance exist
- Manage revenue cycle activities to ensure cost effectiveness, organizational efficiency, and optimal collection rates; collaborate with cross functional teams to address and resolve revenue cycle issues impacting these performance metrics
- Partner with our analytics team to ensure data is measured consistently across all CDOs and vendor partners, and everyone is speaking the same language. Identify performance bottlenecks based on performance analytics and deploy targeted support for problem areas to drive quick resolution
- Ability to communicate concisely and effectively, to varying degrees of audiences, with a thorough understanding of larger business issues; comfortable with metrics, and financial and technical/clinical analyses to present to leaders
- Solid leadership presence to support and engage team, including guiding leaders to understand process changes and updates that can lead to Solider performance metrics. Ability to develop programs and lead process improvement projects by creating buy-in from other revenue cycle leaders and articulating the value these projects provide
- Lean into initiatives to streamline revenue cycle operations and improve overall efficiency. Identify opportunities to reduce costs, minimize denials, and enhance cash flow
- Recognize the resources available to our CDOs related to support and help foster relationships for teams
- Prepare and present revenue cycle metrics, action plans and overall performance of group as well as local level. Comfortable leading training, both in large and small group settings
- Ability to read managed care contracts and apply basic principles
- Ensure that all revenue cycle processes comply with relevant laws, regulations, and payer requirements. Upholds and practices the principles and policies of the Optum Health and UHG Compliance program
Skillsets
- Exceptional strategic thinking, problem-solving, and decision-making skills
- Proven leadership and interpersonal skills with the ability to engage and influence stakeholders at all levels. Ability to effectively communicate with team members, management, and external stakeholders
- Self-driven and personally accountable to achieve results and has internal drive and commitment to achieve those results in the face of difficulty and obstacles
- Solid understanding of revenue cycle processes, healthcare reimbursement models, and regulatory requirements
- Results oriented with the ability to meet deadlines in a fast-paced, dynamic, project-oriented environmenT
- Excellent professional presentation and organization skills, including ability to manage an array of people, projects, and deadlines
- Self-motivated, detail oriented, solid analytical and critical-thinking skills
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
- 12+ years of progressive revenue cycle experience including experience across specialties in a multi-payer setting
- 8+ years of management experience in leading RCM in a high claim volume, ambulatory environment
- 8+ years of experience building / managing a team
- Deep knowledge of healthcare billing, coding, payer rules, and reimbursement methodologies (e.g., Medicare, Medicaid, commercial payers). Familiarity with compliance and regulatory requirements
- Solid understanding of revenue cycle management software, healthcare billing systems, and reporting tools. Proficiency in Microsoft Office Suite, especially Excel for data analysis
- Demonstrated leadership skills with a track record of successfully training, mentoring, and developing teams. Ability to inspire a culture of continuous improvement
- 70% travel required for this role
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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 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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
