Director, Claims Pricing Modernization & Strategy

Join UnitedHealthcare’s Claim Product and Data (CPD) team to help transform how claims are processed. This role leads the strategy and delivery of pricing systems that determine how much is paid for healthcare services—helping reduce costs and improve efficiency across the company.

You’ll work remotely from anywhere in the U.S. and collaborate with leaders to modernize pricing tools and drive innovation using technologies like AI and machine learning.

Key Responsibilities

• Lead pricing strategy and roadmap across the enterprise
• Oversee pricing platforms that process millions of claims
• Manage a team of 14 across business and tech functions
• Drive strategic initiatives and ensure projects stay on budget
• Use data to identify opportunities and build business cases
• Present updates and results to executives and stakeholders
• Collaborate with internal teams and external partners
• Ensure pricing systems align with broader claims strategy

Qualifications

Required:

• 7+ years of experience in business operations or working closely with business operations
• 5+ years in strategy development and planning, project management and transformational and change management practices
• 5+ years of program management experience or managing through significant change initiatives with vision, roadmap, plan
• 5+ years of matrixed leadership experience with matrixed cross functional / cross segment teams experience / cross discipline
• Proven experience leading and supporting a team of direct reports
• Demonstrated experience building effective relationships with leadership
• Demonstrated vision and strategy formulation and demonstration of critical thinking skills, including experience developing and executing a long-term plan
• Demonstrated growth mindset, with an appetite for ambiguity and energy to tackle the new, different and unique challenges, frequently requiring operation at the intersection of business and technology
• Intermediate or above proficiency with PowerPoint and Excel
• Experience with pricing technologies and processes through which billed amounts are adjusted to allowed amounts, based on negotiated contracts and editing; and/or contract loading and/or data
• Health care claims, customer service, provider service, or digital experience

Preferred:

• Experience with Agile and tech development
• Strong systems thinking and enterprise insight
• Experience with Aha! (product management tool)

All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.