Description

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 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 critical function in the Payment Integrity business that is primarily responsible for driving deployment of new reimbursement policies and maintaining the integrity of our existing policies to help ensure claims are paid accurately. A successful candidate will create innovative business processes to yield higher outcomes; and partnering closely with UHC business stakeholders and Optum Policy teams to champion business growth.

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:

• Support the Director with development and implementation of business-level strategies to improve how Payment Policy work gets done, enhancing both process efficiency and process outcomes
• Engage in the development of management reporting to identify root cause impacts and trending to ensure affordability savings meet the needs of the business. Recognizes internal impact(s) of outcomes and reaction of constituents and provides messaging to upper management based upon identified issues
• Monitor and report on operational performance, financial outcomes, and vendor effectiveness to support executive level reporting and Payment Integrity governance forums
• Actively supports the development of all payment policy initiatives and participates in development of business strategies that support the Payment Policy growth
• Ability to influence executive leadership to adopt new ideas, policies and/or approaches
• Lead specific tactical projects/initiatives to achieve operational improvements to meet productivity targets maximizing available resource capacity, capability, and expertise
• Identify opportunities to streamline and automate operations processes. This includes solutions that utilize new technologies; Automation; Globalization; and Process leaning. Create business cases and obtain approvals to facilitate solution implementation
• Utilize tools and techniques to visualize data in easy-to-understand formats, such as diagrams and graphs, as well as create process flows
• Build and maintain relationships with Optum and UHC business partners to ensure program targets are met

You will 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 providing development for other roles you may be interested in.

Required Qualifications:

• Undergraduate degree in applicable area of expertise or equivalent experience
• Proven involvement with claims related initiatives that involve complex regulatory requirements and clinical collaboration
• Proven experience in data analysis and the ability to convey complex or technical information in a manner that others can understand
• Proven ability to comprehend and research CMS regulations and processing requirement for Medicare, Medicaid, and Dual SNP populations
• Proven ability to assist with the management and coordination of divergent business priorities with lean resources
• Proven ability to participate in and support the navigating of complex stakeholder relationships in a matrix environment with politically sensitive concerns
• Demonstrated solid communication skill sets, with the ability to support and present information in a variety of different formats to all levels of stakeholders
• Demonstrated solid MS Office, Microsoft Project, and PowerPoint skills

Preferred Qualifications:

• Certified Professional Coder (CPC) or equivalent coding certification or background
• Demonstrated solid analytic skills to aid assessment of potential program opportunities, evaluation of program success/savings and to evaluate business risk impact
• Proven comprehension of contractual language

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. © 2026 Optum Services (Ireland) Limited. All rights reserved.