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 Director - Training, Payment Integrity provides enterprise leadership for training strategy, delivery, capability building, and performance enablement across clinical and non-clinical Payment Integrity operations. The role supports a global footprint across India, Philippines, Puerto Rico, and the United States, ensuring consistent workforce readiness across clinical reviewers, coders, investigators, nurses, analysts, non-clinical operations, and support teams.
This leader works through training managers, trainers, instructional designers, technical writers, SMEs, and business partners to align learning solutions with PI growth, quality, compliance, productivity, automation, and speed-to-proficiency priorities.
Primary Responsibilities:
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Enterprise Training Strategy & Payment Integrity Alignment
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Define and execute the enterprise training strategy for Payment Integrity, aligned to growth, globalization, quality, compliance, automation, and workforce readiness priorities
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Translate business goals into scalable learning roadmaps across clinical and non-clinical PI value streams including Waste & Error, SIU/Fraud, DRG/Facility, PNI, COB, Subrogation, Credit Balance, Data Mining, and Payment Policy
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Build standardized yet flexible training models that ensure consistent delivery across IND, PHL, PR, and US while allowing account-specific customization
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Own training governance, prioritization, capacity planning, and risk mitigation for onboarding, upskilling, cross-skilling, and transformation programs
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Capability Assessment, Curriculum Strategy & Solution Design
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Lead training needs assessments using performance data, quality trends, hiring forecasts, learner readiness, and operational risk signals
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Diagnose skill gaps across clinical coding, medical record review, claims investigation, payment policy, systems, workflows, and non-clinical operations
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Define learning pathways for new hires, internal mobility candidates, experienced hires, trainers, SMEs, supervisors, and managers
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Partner with Design and Documentation teams to standardize curriculum, simplify content, digitize assets, and build reusable PI foundations with role-specific specialization
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Global Training Delivery & Implementation Excellence
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Oversee global and US training delivery to ensure consistent learner experience, training quality, readiness tracking, and batch execution
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Enable large-scale onboarding and ramp-up for clinical and non-clinical teams across India, Philippines, Puerto Rico, and the US
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Ensure trainer capacity, SME support, agenda readiness, systems access, and OJT alignment are in place before production ramp
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Drive speed-to-proficiency through progressive learning, simulations, live-case exposure, specialty-based learning, and structured 30-60-90 post-training support
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Leadership, Team Management & Resource Optimization
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Lead and develop a distributed training organization comprising managers, trainers, instructional designers, technical writers, knowledge partners, and SMEs
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Build a solid training leadership bench to support clinical, coding, investigative, non-clinical, and transformation portfolios
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Manage training capacity, resource allocation, utilization, and prioritization across geographies and business demands
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Enable trainer upskilling, certification readiness, process immersion, and keeping-skills-alive practices to strengthen credibility and delivery quality
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Stakeholder Engagement, Governance & Business Partnership
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Serve as a strategic training partner to PI senior leaders across clinical and non-clinical operations
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Influence alignment across Operations, Quality, Opx, Talent Acquisition, Talent Development, Design, Documentation, Transformation, and Enterprise Learning teams
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Facilitate leadership discussions on training readiness, hiring dependency, quality remediation, talent mobility, and transformation enablement
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Communicate training risks, dependencies, milestones, and outcomes through executive-ready updates, dashboards, reviews, and business forums
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Measurement, Business Impact & Continuous Improvement
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Define and monitor training effectiveness measures including learner readiness, assessments, throughput, NPS/TSS, quality outcomes, speed to proficiency, productivity, and business impact
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Use analytics, quality trends, operational performance, and learner feedback to prioritize improvement interventions
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Partner with Operations and Quality to reduce performance variance, improve first-time-right execution, and strengthen post-training application
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Quantify value through reduced training time, improved trainer capacity, faster production readiness, improved quality, reduced rework, and optimized cost of learning
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Innovation, Digital Learning & Workforce Transformation
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Champion modern learning approaches including AI-enabled learning, simulations, microlearning, scenario-based practice, digital academies, adaptive assessments, and performance support tools
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Lead training transformation initiatives supporting PI modernization, automation adoption, agentic AI readiness, and future-of-work capability building
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Establish shared clinical and non-clinical foundations that enable fungibility, internal mobility, and faster transition across PI roles and accounts
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Promote continuous learning, knowledge sharing, experimentation, and scalable best-practice adoption across global PI training teams
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Scope & Impact
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Leads enterprise training strategy and execution for Payment Integrity across clinical and non-clinical teams in IND, PHL, PR, and US locations
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Supports a large, complex workforce across multiple PI value streams, clients, processes, platforms, and operating models
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Directly impacts onboarding speed, production readiness, quality, productivity, compliance, operational scalability, talent mobility, and business continuity
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Influences enterprise learning investments, PI academy strategy, workforce transformation, and future-ready capability development
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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 regard 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
Why This Role Matters (Payment Integrity Context):
Within Payment Integrity, training is a strategic enabler of growth, quality, compliance, affordability, and workforce transformation. This role ensures global clinical and non-clinical teams are equipped to make accurate claim decisions, improve production readiness, reduce performance variance, support medical cost savings, and scale future-ready capabilities across the enterprise.
Required Qualifications:
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A bachelor's degree in an allied healthcare or medical discipline (e.g., BPT, BHMS, BAMS, BDS, or MBBS). CPC/CIC/COC certification is preferred
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15+ years of experience in healthcare training, learning strategy, operations training, capability development, or enterprise learning leadership which include 2+ years of Payment Integrity experience with solid exposure to healthcare operations, claims, coding, clinical review, payer operations, compliance, and quality expectations
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Experience managing large-scale new hire training, upskilling, cross-skilling, certification readiness, quality remediation, and transformation enablement programs
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Proven capability to influence senior stakeholders, drive governance, manage risks, and communicate measurable business impact
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Demonstrated ability to lead global or multi-site training teams across clinical and non-clinical portfolios
Preferred Qualifications:
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Experience leading enterprise training across India, Philippines, Puerto Rico, and US delivery models
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Familiarity with PI clinical and non-clinical operations including Waste & Error, SIU/Fraud, DRG/Facility, Data Mining, COB, Subrogation, Credit Balance, and Payment Policy
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Knowledge of CPC/CIC/COC certification pathways, coding education, clinical reviewer development, and specialty-based training models
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Demonstrated solid data-driven decision-making skills with ability to connect learning metrics to operational outcomes
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Demonstrated solid executive presence, stakeholder management, change leadership, training digitization, curriculum simplification, and cross-functional collaboration skills
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Flexible to work in multiple shifts and adhere to RTO guidelines
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.
