Director of Claims Pricing Solutions - Remote

Director Of Claims Pricing Solutions

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Director of Claims Pricing Solutions will serve as the subject matter expert within the Optum Go to Market organization. The role involves collaborating with market, growth, operations, marketing, finance, pricing, and product teams to support growth and renewal strategies for Optum's Payment claims pricing software and services portfolio. Key responsibilities include developing and presenting client-specific solutions, managing stakeholders through the contract lifecycle, demonstrating claims pricing software, and ensuring proposals include the correct solution mix, pricing approach, and value story. Additionally, the role involves providing voice-of-customer feedback, reviewing new solution concepts, identifying target customers, and helping launch new products to the market.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Collaborating with internal cross-functional teams, including internal market, growth, operations, and product teams; and external business partners to support growth and renewal strategies for Optum's Payment claims pricing software and services portfolio
• Developing and presenting client-specific presentations, software solutions, managing stakeholders through the contract lifecycle, and ensuring proposals include the correct solution mix, pricing approach, contract terms, and value story
• Providing voice-of-customer feedback, reviewing new solution concepts, identifying target customers, and helping launch new products to the market
• Presenting Optum's full pricing software capabilities
• Applying advanced analytical and quantitative approaches to problem-solving for large complex clients with multiple lines of business and/or products and/or new-to-market solutions
• Using communication skills to influence and negotiate
• Working directly with customers to define other new pricing needs and requirements
• Supporting Optum Business Partners with questions around integration
• Compiling documentation: processes and procedures (including but not limited to client or system-specific tracking)
• Prioritizing projects and outcomes identified by the Executive Team
• Providing insight related to savings targets, budget and forecasting, and increased medical and administrative savings opportunities
• Driving execution on new sales opportunities and developing new pricing models for emerging products and content, including sales presentations, RFP responses, and providing expertise in pricing new deals and renewals as well as more complex vendor and tri-party agreements
• Ensuring that contracts are reviewed and represent the best interest of the business

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:

• 8+ years of claims pricing experience
• Experience translating, configuring, and testing pricing terms into a contract management software tool
• Experience with facility and professional contracting and reimbursement across Medicare, Medicaid, and Commercial
• Health plan experience in facility contract configuration, claims, network contracting or a technology division
• Claims system and/or contract modeling experience with at least one of the following: Cognizant: Facets/NetworX, QNXT/NetworX; HealthEdge: Health Rules Payer; Advantasure: iKA Claims; Epic: Tapestry; 3M: GPCS; RAM: HealthSuite; and/or Conduent/HSP: MediTrac; HealthEdge Source; Zelis: Payer Compass; Reimbursement Manager (REM); PMMC: Contract Modeling; Strata: Market Reimbursement Intelligence or Contract Analytics; MD Clarity: RevFind or Clarity Flow; ClaraPrice: Payer Contract Management
• Proven excellent verbal and written communication skills. Ability to influence and negotiate effectively

Preferred Qualifications:

• 10+ years of claims pricing experience
• Experience using Optum pricing tools: Rate Manager, Payment System Interface, and/Reimbursement Manager
• Experience documenting client operational, pricing, and technical workflows
• Account management experience
• Project management experience
• Proven experience in leading cross-functional teams and managing large-scale projects
• Knowledge of emerging trends and technologies (AI) in healthcare
• Understanding of healthcare industry regulations and compliance requirements
• Proven track record in managing executive initiatives and driving strategic projects

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.