Associate Director, Eligibility Configuration - Remote

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.
The Associate Director, Eligibility Configuration, is a critical leadership role accountable for setting strategic direction and driving operational excellence across large-scale eligibility and provider attribution processes. The position oversees complex, high-volume operations, ensuring accuracy, timeliness, and compliance while fostering innovation through automation and technology enhancements. The role requires solid collaboration with internal stakeholders, external clients, and technology partners to deliver seamless execution and proactive issue resolution, ultimately supporting accurate payments and provider/member alignment.
This role is accountable for 1.8M members, 21 payors with over 1000k eligibility files across 18 markets and 5 platforms.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:

• Set strategic direction and execute business plans to achieve organizational goals and operational excellence
• Lead and manage a large team of 150+ employees across multiple staffing models, including domestic, offshore, contractors, and transaction-based billing
• Provide operational leadership for eligibility configuration across multiple claim and clinical systems, including Facets, IDX, Monarch, EPIC, and Xcelys
• Partner with local markets and finance teams to ensure accurate eligibility reconciliation impacting PMPM (Per Member Per Month) payments from payors
• Oversee timely loading of eligibility files and ensure any discrepancies are resolved with high accuracy and speed
• Engage with external clients to define and maintain eligibility file requirements, ensuring seamless execution of weekly and monthly processes
• Drive automation initiatives by enhancing tools and technology in collaboration with multiple technology partners
• Reduce single-resource and platform-specific dependencies by building cross-trained teams and increasing role flexibility to ensure continuity, scalability, and operational resilience
• Leverage data analytics to interpret trends, proactively identify issues, and implement corrective actions
• Collaborate with market operations leads and issue management teams to research and resolve escalated issues promptly
• Partner with Provider Data Operations to improve provider and member attribution accuracy
• Ensure claim and clinical readiness for delegation changes by the effective date, maintaining compliance and operational integrity
• Lead eligibility configuration and implementation for OptumCare growth, expansions, and de-delegations, ensuring readiness across platforms and markets
• Lead eligibility readiness for the California claims migration to Facets, partnering across technology and market teams to maintain stability and compliance
• Represent eligibility operations for OptumCare platforms in governance and enterprise forums, ensuring alignment on standards and execution

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:

• 5+ years of leadership experience in healthcare operations
• Proven experience in driving operational excellence through process re-engineering and technology integration
• Solid understanding of healthcare payor and provider landscapes
• Proven ability to collaborate and influence internal and external business partners
• Proven success leading matrixed and geographically dispersed teams, including offshore and/or multi market models, while maintaining consistent performance and operational control

Preferred Qualifications:

• Experience leading eligibility, member, or enrollment operations in a multi-payor healthcare environment, including ownership of eligibility configuration, file ingestion, and reconciliation processes
• Experience driving operational efficiency and workforce flexibility, including balancing capacity to demand, improving resource utilization, and scaling teams to support growth or change initiatives
• Experience leading teams through transformation or scale, including onboarding new payors, markets, or platforms without degradation to quality or timeliness
• Demonstrated experience with configuration across multiple claim platforms (e.g., Facets, EPIC, IDX, Monarch, Xcelys) within a multi-market or scaled operating model
• Proven success reducing single-resource and platform-specific dependencies by implementing cross-training, standardized work, and shared ownership models
• Proven solid verbal, written, interpersonal, and presentation skills

*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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.