Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers technology-enabled care and resources to help millions of people live healthier lives. The Sr. Consultant will independently lead assigned healthcare payer operations workstreams, conduct data and financial analyses, develop client-ready deliverables, manage client communications, identify risks, and support junior team members and practice development initiatives.
Responsibilities
- Structure the approach and analysis for assigned workstreams largely independently, with guidance from the Project Manager or engagement leadership as needed
- Develop and deliver client-ready work products, including analyses, process documentation, current-state and future-state materials, issue summaries, recommendations, and presentation content
- Lead client communications related to assigned workstreams and, at times, support communications for work performed by more junior team members
- Establish timelines for assigned workstream activities and assist junior team members with timelines, deliverables, and follow-through in accordance with overall project requirements
- Serve as a major contributor to team problem solving across the full project scope, including structuring and facilitating problem-solving sessions with support from the Project Manager
- Proactively anticipate challenges, dependencies, and risks within assigned areas and make practical adjustments or recommendations to address issues
- May serve as project lead for smaller, more templated engagements or work in familiar payer operations terrain
- Communicate effectively and accurately in writing and verbally with clients, prospects, team members, and practice leaders
- Apply payer operations knowledge across domains such as claims operations, payment integrity, provider operations, member and provider services, appeals and grievances, compliance, operational reporting, and performance management
- Conduct data analysis and financial analysis to identify issues, root causes, business impacts, and practical solution options
- Translate analysis, stakeholder input, and project findings into clear insights and actionable recommendations
- Build credibility as a knowledgeable contributor on payer operations topics and maintain a foundational understanding of healthcare industry dynamics
- Maintain awareness of Optum data sets, tools, research, assets, and methods used by the practice to support client delivery
- Lead or participate in practice development projects, including business process improvement, knowledge management, reusable assets, and internal capability building
- Support junior team members by helping them structure work, understand expectations, improve deliverable quality, and meet project timelines
- Contribute to a collaborative, team-oriented work environment that encourages high-quality delivery, learning, and practical solutions
- Participate in internal initiatives that strengthen client delivery, improve consistency, and advance the maturity of payer operations offerings
Skills
- • 3+ years of relevant healthcare work experience, including healthcare insurance, healthcare operations, or healthcare management consulting
- • 3+ years of experience across multiple lines of healthcare payer business, including Commercial, Medicare, Medicaid, ACA, and Family/Individual coverage, among others
- • 3+ years of experience with payer operations in one or more areas such as claims operations, payment integrity, provider operations, member/provider services, operational controls, reporting, or financial performance
- • 3+ years of experience in data analysis and financial analysis
- • 3+ years of experience with Program and operational coordination including tracking, presentation, reporting, timeline management, and follow-through
- • Ability to travel up to 50%
- • 2+ years of external client-facing experience at a consulting firm, including Big 3, Big 4, Big 6, boutique, or comparable advisory experience
- • Payment Integrity experience, including audit, recovery, prevention, payment accuracy, claims editing, vendor operations, or operational optimization initiatives
- • Experience applying process improvement or implementation methodologies such as Lean, Six Sigma, Agile, or similar approaches
- • Experience mentoring, coaching, or assisting junior-level staff
- • Demonstrated ability to structure analytical reasoning and solution-focused problem solving
- • Ability to participate in and contribute to cross-functional teams
- • Ability to work in complex, highly matrixed, fast-paced environments
- • Solid interpersonal and relationship-management skills, including demonstrated customer or client-facing experience
- • Solid written and verbal communication skills, including the ability to develop clear, client-ready presentations and work products
- • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Flexibility to work remotely from anywhere within the U.S.
- Career development opportunities
Company Overview
Company H1B Sponsorship