Lead ownership and stability of Facets Claims (workflow, adjudication, pricing, accumulators, pends). Provide technical leadership, mentor engineers, drive upgrades/releases, support UAT and production readiness, and champion automation and AI-enabled improvements to claims validation and monitoring.
Requisition Number: 2359542
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:
Required Qualifications:
Preferred Qualifications:
Expectations:
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.
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:
- Facets Claims Ownership, Upgrades & Releases
- Own end to end delivery and stability of Facets Claims including claims workflow, adjudication, pricing, accumulators, pends, and explanation codes. Lead claims enhancements, defect remediation, and Facets Claims upgrades through impact analysis, regression, UAT support, mock go live, and production readiness. Ensure claims accuracy, First Pass improvement, compliance, and minimal rework across all releases
- Technical Leadership & Cross Functional Collaboration
- Provide Grade 27 level technical leadership by guiding solution design, reviewing configurations and deliverables, and mentoring engineers and vendor teams. Partner closely with Business SMEs, QA, Finance, Infrastructure, and vendors to translate requirements into scalable Facets Claims solutions, resolve complex issues, and ensure high quality, on time delivery across enhancements, releases, and production support
- Automation & Continuous Improvement (AI First Mindset)
- Drive continuous improvement through an automation first and AI aware mindset. Proactively identify opportunities to reduce manual effort, improve accuracy, and enhance operational efficiency using automation, intelligent workflows, and emerging AI capabilities. Support responsible AI experimentation and adoption for claims validation, monitoring, and insights while ensuring solutions remain scalable, compliant, and aligned with enterprise standards
- 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 regards 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
- Design, develop, and deploy AI-powered solutions using no-code, low-code, and advanced platforms, translating business needs into scalable applications that enhance products, workflows, and decision-making
Required Qualifications:
- Bachelor's degree or equivalent experience
- Solid hands-on experience with Facets, Oracle SQL / PL SQL - advanced proficiency
- Senior individual contributor responsible for end-to-end ownership of Facets Claims solutions, proven ability to provide solid technical leadership while driving stability, modernization, automation, and continuous improvement across claims processing
Preferred Qualifications:
- Knowledge of Java or any modern programming language (e.g., C#, Python)
- Exposure to automation tools, scripting, or AI assisted validation
Expectations:
- Operates independently with minimal oversight
- Owns mission critical Claims components and outcomes
- Influences technical direction and delivery quality
- Acts as a trusted technical advisor to leadership and business partners
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.
Optum Pune, Maharashtra, IND Office
Pune, India, India
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