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Director of Provider Reimbursement - Eden Prairie, MN

UnitedHealth Group

Eden Prairie, MN
Job Code:
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Job Details

Director of Provider Reimbursement - Eden Prairie, MN(Job Number:719020)

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)


The Director of Provider Reimbursement is responsible for developing programs, policies and strategies to ensure that contracted rates and reimbursement policies are applied accurately for company affiliates. Directors of Provider Reimbursement will analyze claims, pre and post payment, to ensure contracts and reimbursement policies and procedures are priced accurately; review claim disputes to verify correct pricing and analyze claim inquiry data to determine root cause of errors; recommend system changes, training and process improvements to prevent future errors; work with both internal and external customers to identify and resolve complex problems; assist company affiliates with initial deployment and ongoing support of systems and processes to leverage national network rates and policies.


This role will be accountable for helping drive financial modeling and client facing presentations denoting Optum’s affordability services.  In addition this role will support reconciliation teams for both pharmacy and client contract management in optimizing the outcomes across the entire book of OptumRx business.


Primary Responsibilities:

  • Develop and execute strategies for a function or discipline that span a large business unit or multiple markets / sites
  • Direct others to resolve business problems that affect multiple functions or discipline
  • Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external)
  • This role will support strategy, setup & maintenance for large clients within the OptumRx portfolio
  • Candidates applying for this role will have financial or economic modeling experience, client or executive material development and presentation experience
  • Developing and leading financial modeling teams will benefit all applicants


Job Provider Reimbursement
Primary Location US-MN-Eden Prairie
Other Location 
Organization OptumRx Industry Reltn & Trade
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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