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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Role Summary
We are seeking a high-impact Associate Director - RCM Operations to lead large-scale back-office delivery while owning and driving end-to-end revenue outcomes.
This role goes beyond operational delivery and requires a leader who can connect back-office performance with upstream RCM drivers, influence cross-functional teams, and deliver measurable improvements in cash collections, AR days, denial rates, and net revenue realization.
The ideal candidate brings deep RCM expertise, a solid cost and efficiency mindset, and the ability to leverage automation, analytics, and AI to transform operations.
Primary Responsibilities:
- Outcome Ownership (Revenue & Performance Metrics)
- Own and drive improvement in key RCM outcome metrics, including:
- Cash collections / cash acceleration
- AR days reduction
- Denial rates & overturn rates
- Gross Collection Rate (GCR) / Managed Net Collection Rate (MNCR)
- Write-offs and revenue leakage reduction
- Translate operational performance into measurable financial outcomes
- Build solid visibility and governance around metric performance, trends, and drivers.
- Back-Office Operations Leadership: Lead large-scale back-office RCM functions (AR follow-ups, denials, payment posting, coding support, adjustments)
- Ensure high performance on:
- Productivity
- Quality
- SLA adherence
- Drive operational rigor and standardization to support consistent delivery of outcomes
- Closed-Loop Feedback with Front & Mid Office
- Actively collaborate with front-end and mid-cycle teams to address upstream issues impacting back-end outcomes
- Establish and drive a closed-loop feedback mechanism to:
- Identify root causes of denials, rejections, and delays
- Fix process gaps at source (eligibility, authorization, coding, billing)
- Influence cross-functional stakeholders to improve first-time-right rates and reduce rework
- RCM Domain Expertise & Insight-Led Problem Solving
- Leverage deep understanding of the end-to-end RCM lifecycle to diagnose systemic issues.
- Use data and analytics to identify revenue leakage, bottlenecks, and inefficiencies.
- Provide actionable insights to clients and internal teams to improve overall RCM performance
- Cost Optimization & Efficiency Focus
- Drive initiatives to reduce cost-to-collect while improving revenue outcomes
- Identify and act on key levers:
- Productivity improvement
- Process simplification
- Automation adoption
- Build a culture focused on efficiency, cost consciousness, and value delivery
- Transformation, Automation & AI Enablement
- Identify and implement automation and AI-driven solutions across RCM workflows
- Drive use cases such as:
- Intelligent AR prioritization
- Denial prediction & prevention
- Automated workflows and exception handling
- Partner with technology teams to align RCM domain needs with digital solutions
- Client & Stakeholder Management
- Engage with clients and onshore stakeholders as a value-driven partner, not just a delivery owner.
- Lead governance discussions with focus on:
- Outcome metrics
- Insights and root causes
- Continuous improvement opportunities
- Build solid credibility through data-backed recommendations and execution.
- Process Excellence & Innovation
- Lead continuous improvement initiatives (Lean / Six Sigma) focused on both efficiency and revenue impact.
- Standardize and scale best practices across accounts.
- Encourage innovative and out-of-the-box thinking to solve complex RCM challenges.
- People Leadership
- Lead and develop large teams (300-500+ FTEs), including managers and supervisors.
- Build a high-performance culture focused on:
- Accountability for outcomes (not just tasks)
- Capability building in RCM domain
- Continuous improvement mindset
- Transition & Change Management
- Lead/support transitions of RCM processes into offshore/global delivery
- Ensure effective stabilization with solid focus on outcome continuity and improvement
- Drive adoption of new processes, tools, and transformation initiatives
- Governance & Compliance
- Ensure adherence to client SLAs, compliance standards (HIPAA), and internal controls
- Proactively identify and mitigate risks impacting operations and revenue outcomes
- Establish solid governance frameworks for performance tracking and reporting
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Education: Graduate (MBA preferred)
- Experience: 12+ years in US Healthcare RCM / BPO operations
- Proven experience managing large-scale back-office operations (300-500+ FTEs)
- Solid exposure to end-to-end RCM lifecycle and performance metrics
Preferred Qualifications:
- Lean Six Sigma certification
- Experience in transformation / automation programs
- Exposure to analytics and digital RCM solutions
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.