Director, Payer Systems and Applications Technology Consulting - Remote; opens tab

Position: Director, Payer Systems and Applications Technology Consulting - Remote (opens in new tab)

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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

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:

• Act as a trusted advisor across client business and technology organizations, building durable relationships with executives, platform owners, operational leaders and delivery partners
• Assess current-state business processes, applications, architecture, data, integration patterns and operating models to identify transformation priorities and constraints
• Formulate technical solution architectures for payer platform implementation, migration, modernization, optimization and application integration initiatives
• Build consensus among client stakeholders and translate complex technical choices into clear business implications, decisions and implementation roadmap
• Lead or oversee implementations and modernization programs involving core administrative payer platforms such as Tri Zetto Facets, Health Rules Payer, QNXT, Epic, Tapestry, ika Systems or comparable platforms
• Guide work across claims, enrollment, billing, benefits, provider, pricing, customer service, finance and related payer capabilities, including integrations with digital, data, clinical and enterprise applications
• Own end-to-end technical delivery for complex payer system and application transformation programs, with accountability for outcomes, quality and client experience
• Establish delivery governance, integrated plans, decision rights, architecture oversight, quality controls and transparent executive reporting across multiple work streams and vendors
• Manage scope, budget, schedule, resources, dependencies, risks, issues and changes; proactively address delivery variance and facilitate fact-based client decisions
• Serve as the senior escalation point for delivery teams, remove blockers and lead recovery planning when commitments, quality or outcomes are at risk
• Lead multidisciplinary teams that may include solution architects, product and business analysts, engineers, configuration specialists, data and integration teams, testers, program managers and change leaders
• Apply Agile, hybrid or structured delivery methods appropriate to the client environment, including capability planning, release planning and Program Increment planning where applicable
• Demonstrate working knowledge of AI, generative AI, intelligent automation, machine learning and analytics concepts relevant to healthcare payer operations and technology delivery
• Identify and prioritize practical AI opportunities across claims, benefits, provider data, enrollment, customer service, testing, knowledge management, configuration analysis and program delivery
• Help clients develop AI-enabled transformation roadmaps, value hypotheses, pilot plans, operating-model changes and measurable adoption outcomes
• Participate in pursuits, solutioning, proposal development, presentations and negotiations; expand existing accounts by connecting client needs to differentiated advisory and technology capabilities
• Contribute to annual sales objectives, including demonstrated success…