Revenue Cycle Management - Business Process Consultant - 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.

This role is responsible for leading the design and development of operational digital playbooks that support RCM Middle Operations, including Clinical Documentation Integrity (CDI), Coding, and Health Information Management (HIM). These playbooks serve as foundational tools for the Client Integration and Transformation team during the onboarding of new provider clients, ensuring consistent, scalable, and compliant operational frameworks.

In addition to supporting new client implementations, the role plays a critical part in the centralization of operational processes across an existing portfolio of 10+ clients. This includes embedding Optum's best practices, standardizing workflows, and driving performance optimization.

The consultant also supports Regulatory Change Management by translating evolving compliance requirements into actionable updates within RCM Middle Operations, ensuring timely adoption and operational readiness across all client environments.

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:

• Operational Playbook Design & Development
  • Lead the design, development, and continuous enhancement of the RCM Middle Operations Digital Playbook, ensuring alignment with Optum's enterprise standards and client-specific needs
  • Translate complex operational workflows into standardized, scalable, and system-agnostic playbook content, including process maps, standard operating procedures (SOPs), and Peak Efficiency Models (PEMs)
  • Collaborate with subject matter experts (SMEs) across CDI, Coding, and HIM to capture current-state processes and define future-state best practices
• Client Integration & Transformation Support
  • Serve as a strategic partner to the Client Integration/Transformation team, providing playbook-driven guidance during new client onboarding initiatives
  • Ensure that operational frameworks are tailored to support client-specific requirements while maintaining consistency with Optum's best-in-class standards
• Centralization of Existing Client Operations
  • Support the centralization of operations across the existing portfolio of 10+ clients by applying Optum best practices, standardizing workflows, and identifying opportunities for automation and efficiency gains. Facilitate knowledge transfer and change management to ensure smooth transitions and adoption of centralized models.
• Regulatory Change Management
  • Lead or support the implementation of regulatory changes within RCM Middle Operations, ensuring timely updates to playbook content and operational workflows
  • Partner with compliance, legal, and operational leaders to interpret regulatory requirements and translate them into actionable process updates
• Governance & Quality Assurance
  • Participate in playbook governance processes, including content review, stakeholder alignment, and approval workflows for new or revised materials
  • Ensure all documentation meets quality, compliance, and usability standards for internal and client-facing use
• Cross-Functional Collaboration & Leadership
  • Act as a liaison between Content Management, Training Delivery, Compliance Coding QA, and Quality Assurance teams to ensure cohesive and aligned operational strategies
  • Provide mentorship and guidance to junior team members and contribute to a culture of continuous improvement and innovation
• Strategic Communication & Stakeholder Engagement
  • Engage with internal and external stakeholders to communicate updates, gather feedback, and align transformation goals
  • Support communication strategies related to Centers of Excellence (CoEs) and other enterprise-wide initiatives

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:

• Healthcare Revenue Cycle Expertise
  • 5+ years of experience in Revenue Cycle Management (RCM), with a strong focus on Middle RCM functions such as Clinical Documentation Integrity (CDI), Coding, and Health Information Management (HIM)
  • Deep understanding of payer-provider dynamics, compliance standards, and regulatory frameworks impacting RCM operations
• Change Management & Regulatory Implementation
  • Experience supporting Regulatory Change Management within healthcare operations, including the ability to interpret new regulations and update operational content accordingly
  • Ability to lead or support change initiatives across multiple client environments, ensuring compliance and operational readiness
• Cross-Functional Collaboration
  • Solid collaboration skills with the ability to work across Content Management, Training Delivery, Compliance Coding QA, and Quality Assurance teams
  • Experience in leading or contributing to Centers of Excellence (CoEs) and enterprise-wide transformation programs
• Analytical & Process Improvement Skills
  • Proficiency in process analysis, workflow optimization, and identifying automation opportunities
  • Ability to conduct gap assessments, conceptual analysis, and develop innovative solutions to improve operational performance

Preferred Qualifications:

• Operational Playbook Development
  • Proven experience in designing, authoring, and maintaining operational playbooks, including process mapping, standard operating procedures (SOPs), and Peak Efficiency Models (PEMs)
  • Familiarity with playbook governance processes, including stakeholder engagement, content validation, and version control
• Client Integration & Transformation Support
  • Demonstrated ability to support client onboarding and transformation initiatives, including the ability to translate operational best practices into scalable, client-ready frameworks
  • Experience working with Client Integration/Transformation teams to ensure seamless adoption of standardized processes
• Communication & Documentation
  • Excellent written and verbal communication skills, with the ability to create clear, concise, and actionable documentation for diverse audiences
  • Experience in leadership presentation and facilitating stakeholder alignment on operational strategies
• Technology & Tools Proficiency
  • Familiarity with Epic systems, Scribe, Zingtree, Smartsheet, and Power BI for documentation, training, and performance tracking
  • Understanding of data privacy and security protocols, especially in handling PHI and system access within client environments

*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 $89,900 to $160,600 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.