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.
Operations Payment Integrity within Optum Payer Operations is responsible for driving the development and execution of medical cost savings growth for UnitedHealthcare and Commercial client health plans by ensuring payment accuracy to support the enterprise objectives. The Operations Ideation & Growth function drives significant medical cost savings from claims received by health care providers through all lines of business / Health plans in parallel to other operations within Payer Payment Integrity, technology, analytic & enablement teams.
This is a global leadership role, hired in Ireland, leading the Competitive Intelligence function within the non-clinical payment integrity portfolio. Competitive Intelligence exists to ensure that overpayment value present in the market is identified and recovered by our own operation rather than lost to third-party recovery vendors. The team pairs experienced claims platform auditors with business analysts to uncover overpayments through exploratory auditing and self-generated analytic inventory, and to detect, size and recapture value leaking to the external market beyond the standard post-payment review window. The successful candidate will define the competitive strategy, lead the ideation and audit engine that delivers it, and produce measurable outcomes in market share, medical cost savings, revenue and affordability.
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:
- Lead the enterprise Competitive Intelligence portfolio and growth strategy across non-clinical Payment Integrity products delivering medical cost savings, affordability, revenue and market share growth
- Own external signal detection and opportunity generation. Build an intelligence-led model that surfaces new opportunity from provider billing trends, competitor activity, payer behaviour, claim patterns, regulatory change, rejected inventory and white space
- Drive the end-to-end opportunity lifecycle, signal detection, lead generation, sizing, financial validation, business case, governance approval, deployment and realized value, against affordability and growth commitments
- Reduce external leakage and displace vendor spend. Quantify and eliminate leakage, expand internal capability to displace third-party vendors, and convert market share gains into measurable external spend reduction
- Build AI-powered intelligence and automation capability. Lead adoption of AI, machine learning, predictive analytics, agentic workflows and contract intelligence to improve signal generation, identification precision, auditor productivity and deployment velocity
- Accelerate claim lifecycle innovation and prevention. Partner with Product, Operations, Analytics and Technology across pre-payment prevention, payment accuracy, post-payment recovery and root-cause remediation to shift value upstream
- Provide executive portfolio governance. Maintain visibility of market dynamics, competitive positioning, vendor performance, pipeline health, forecast accuracy and value realization through established operating reviews
- Develop a high-performing global organization. Build and lead a distributed team of competitive intelligence, audit and analytics professionals, deepening market and platform expertise and a culture of accountability and innovation
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:
- Bachelor's degree in Health Administration, Business, Data Science, Public Health, or a related field, or equivalent professional experience
- Proven extensive experience in healthcare payment integrity, claims auditing, medical cost management, or related healthcare functions
- Proven extensive experience in people leadership, including leadership of leaders across multiple locations or time zones
- Proven extensive experience taking payment integrity or recovery opportunities through the full lifecycle, from identification and sizing through deployment and value realization
- Proven solid experience in competitive intelligence, third-party vendor performance analysis, market share strategy, or insourcing strategy
- Proven experience applying AI, machine learning, advanced analytics, or intelligent automation to operational or analytical processes
Preferred Qualifications:
- Project management and/or Agile/Scrum certification
- Proven solid experience with U.S. non-clinical payment integrity products, including Coordination of Benefits, data mining, provider outreach, contract auditing, or recovery programs
- Proven solid experience in financial analysis, opportunity sizing, and pipeline prioritization
- Proven experience deploying machine learning models or AI-assisted review capabilities into live operational workflows
- Proven experience influencing executive-level stakeholders within matrixed, multinational organizations
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.
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