Full Description

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.

Primary Responsibilities

• RCM Operations & Process Management
• Oversee end-to-end Revenue Cycle Management processes, including claims processing, denial management, and payment posting
• Drive process improvements and implement automation strategies for efficiency
• Ensure adherence to SLAs and KPIs for operational excellence
• Compliance & Audits
• Ensure compliance with regulatory guidelines such as HIPAA, SOX, and corporate standards
• Participate in internal and external audits and maintain accurate documentation
• Align processes with organizational and industry compliance requirements
• Stakeholder Management
• Communicate effectively with clients, leadership, and cross-functional teams
• Build strong relationships with business partners and manage escalations promptly
• Act as a key liaison for all RCM-related matters
• Team Leadership & Training
• Lead and mentor teams to achieve performance goals
• Foster a culture of continuous improvement and data-driven decision-making
• Analytics & Decision-Making
• Utilize data analysis to identify trends and drive strategic decisions
• Conduct root cause analysis and implement predictive analytics for process optimization
• Prepare and present reports to leadership for informed decision-making
• Planning & Budgeting
• Develop operational budgets and ensure cost control
• Lead projects focused on process improvement and automation
• Create and execute RCM roadmaps aligned with business objectives
• 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 regard 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