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.

Clinical Solutions is a rapidly growing business within OptumInsight that serves at the intersection of payers, providers and patients. Clinical Solutions generates $3B in revenue by delivering technology enabled solutions to facilitate accurate patient risk and care gap identification, impactful patient/provider engagement, audit proof coding and documentation and tangible care quality improvement.

The SVP, Clinical Solutions will report to the Managing Director of Ireland.

This role provides global leadership in execution and operations for prospective and retrospective risk adjustment products and services including: risk adjustment coding, encounter submissions and data operations. This role is responsible for the end-to-end accountability of functions including P&L ownership and management across all functions delivering on value proposition sold to health plan and health system clients. The position ensures exceptional performance of existing capabilities while building and deepening client relationships and driving profitable growth, ongoing advancement of operational model, integration of new capabilities and services, vendor management oversight and direct client engagement related to campaign execution.

Primary Responsibilities:

• Manage the executive enterprise relationships and performance of a highly complex and federal regulated suite of products and services, ensuring best in class delivery
• Drive performance through in depth understanding of U.S. federal and state requirements and complex regulations driving business volumes
• Responsible for the organization’s RAF performance
• Drive innovation through team by leveraging data, analytics and the implementation of tools, technology and automation
• P&L Management—providing comprehensive and balanced direction on key decision support through strong financial acumen and understanding of results; responsible for driving sustained improvement in underperforming areas, achieving all revenues, IOI and NPS targets
• Build and develop teams that can scale while delivering excellence; hire and develop members of the leadership team and continue to mentor and grow team from within
• Ensure execution of product, service or process decisions that will impact the entire enterprise, industry and/or marketplace
• Translate Voice of Customer; qualify business requirements and objectives to key stakeholders
• Identify opportunities and evaluate new economic models to accelerate growth of existing services
• Lead Execution of Risk Adjustment Operations including:
  • Effective delivery of services per our commitments to clients, through execution across functions, transformational initiatives and delivery contractual and regulatory service level agreements
  • Ensure compliance and quality of services through execution within organizational and regulatory requirements, utilizing needed risk and controls, incorporating continuous improvement and monitoring employee and team performance against expectations
  • Plan and manage financial viability of operations - managing budget, developing/executing strategies against objectives, utilizing metrics to drive execution excellence and ensuring effective workforce strategies
  • Effective engagement of team members – foster culture of trust and engagement, deliver successful communication strategies and manage performance against expectations
    
    

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:

• Successful leadership experience in leading and managing people
• P&L and/or extensive budgeting experience as well as strategic planning and development
• Experience leading large operations teams in a heavily matrixed environment which requires the ability to influence and hold accountable without direct oversight
• Prior leadership experience including business development/new market development and leading large-scale operations teams
• Prior leadership experience building and maintaining service-oriented culture across remote field based organizations
• Demonstrated ability to build and maintain effective relationships with external partners
• Proven ability to lead through collaboration with matrix partners across Compliance, Analytics, Legal, Finance and Product to achieve business objectives
• Solid communication and leadership skills; the ability to roll up sleeves and influence peers, partners and leadership across the enterprise to make the most effective and strategic decisions aligned with our new strategy and priorities
• Ability to travel 10%, domestic and international

Preferred Qualifications:

• Progressive professional roles focused on client engagement, delivery, operations and/or growth
• Senior Leader with experience of P&L management with ability to achieve financial results, healthcare related industry operations optimal
• Expert level of proficiency to influence in driving results and outcomes leading large global & remote/virtual teams a matrix organization with enterprise focus
• Expert level of proficiency driving business performance in a high growth environment

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.

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.

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. © 2024 Optum Services (Ireland) Limited. All rights reserved.