Requisition Number: 2366302 Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. This role is responsible for driving performance across Optum's Coding Intelligence print and digital product lines, with direct accountability for revenue execution, operational performance, and vendor management. The position owns quota delivery, oversees production and customer service operations, and ensures alignment between sales, fulfillment, and partner execution to meet revenue and service expectations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Revenue & Quota Ownership - Own and deliver quota across print (books) and electronic (digital) product lines - Drive revenue performance through pipeline management, renewals, and new business development - Ensure solid execution across both print and digital revenue streams - Monitor performance and take action to close gaps against quota Team Leadership - Lead and develop a team of 6 direct reports - Provide coaching, performance management, and deal support - Drive accountability for individual and team performance against revenue and operational goals Vendor Management & Oversight - Oversee and manage third-party vendor for small account management/customer service - Direct 50 indirect resources supporting customer service and small account management - Ensure performance aligns to SLA expectations and customer service standards - Serve as co-owner of third-party vendor print relationship - Support coordination of print production and fulfillment processes - Ensure vendor performance meets capacity, quality, and timeline requirements Operations & Execution - Manage execution across both print and digital channels - Ensure alignment between sales demand, production capacity, and delivery performance - Drive consistent execution of fulfillment and customer service operations - Address operational gaps impacting throughput, SLA adherence, or customer experience Cross-Functional Leadership - Partner with product, marketing, and operations teams to align on: - Sales strategy - Product delivery - Customer experience - Act as escalation point for issues impacting revenue performance or delivery Key Performance Metrics - Monthly and quarterly quota attainment - Revenue performance across product lines - SLA adherence across operations and customer support - Customer satisfaction - Vendor performance against defined expectations 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: - 10+ years of sales leadership experience with quota responsibility - 10+ years of experience leading and developing direct and indirect teams - 5+ years of experience managing third-party vendors or outsourced teams with accountability for performance Preferred Qualifications: - Experience operating cross-functionally across sales, operations, and product teams - Solid communication and leadership skills, with the ability to influence internal and external *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 $ $75,000 to $160,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. 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.

Role Description The Manager, Stop Loss Claims, will play a critical role in supporting the A&H claims organization by performing claims adjudication functions, managing complex, high-dollar and high-ambiguity stop loss claims, employing cost containment solutions, serving as a senior escalation point, and applying expert judgment to drive consistent, high-quality outcomes. This role will be responsible for some personal claims production including, but not limited to, high dollar and complex stop loss claim reimbursement requests and will assist with overall claims department operations. It is designed to complement current claims leadership by adding depth of expertise, decision-making capacity, and mentorship through influence and credibility. Responsibilities - Stop Loss Claims Oversight - Serve as a senior escalation point for complex, high-dollar, or high-risk stop loss claims. - Review and evaluate claims requiring eligibility or medical necessity review, advanced contractual interpretation, medical judgment, or financial analysis. - Apply expert judgment to claim decisions that materially impact financial outcomes. - Identify trends, risks, and opportunities related to claim determinations and outcomes. - Support loss mitigation and cost containment through industry knowledge and expertise. - Participate in daily claim processing, escalated claim reviews and decision making. - Perform monthly and year-end aggregate claim reporting audits and review prior to referral to senior management. - Partner with internal teams to ensure consistent application of stop loss provisions and claims philosophy. - Collaboration & Influence - Work closely with existing management, claims leadership, underwriting, and operations teams. - Provide insight and recommendations on claims-related matters that influence pricing, program structure, and risk assessment. - Function as a trusted internal resource for complex claims discussions and decision-making. - Assist underwriting department in setting reserves for ongoing claimants. - Mentorship & Knowledge Sharing - Mentor and coach claims professionals through guidance, case review, and knowledge sharing. - Contribute to the development of training content or informal learning sessions as appropriate. - Elevate claims capability across the organization by sharing best practices and technical expertise. - Vendor & Partner Interaction - Engage with TPAs, carriers, and external partners on complex claims matters as needed. - Help manage, interpret and escalate reporting from TPA partners as needed. - Support alignment between internal claims philosophy and external partner execution. - Stay abreast of industry changes as related to emerging medical and pharmacy trends as well as cost containment solutions. Qualifications - Bachelor’s degree or equivalent experience required. - 10+ years of hands-on medical stop loss claims experience, including responsibility for complex, high-dollar, and high-ambiguity claims and understanding of self-funded claim funding processes. - Expert level understanding of physician and hospital billing practices, medical terminology, case management and utilization review reporting and industry claim processing best practices. - Demonstrated expertise interpreting stop loss contracts, plan documents, and policy language, including exclusions, limitations, aggregating specifics, lasers, and reimbursement thresholds. - Strong understanding of medical claims adjudication, including eligibility, coordination of benefits, medical necessity considerations, and primary drivers of large claims. - Proven ability to apply sound, defensible judgment in non-standard claims scenarios where documentation is incomplete, facts are disputed, or precedent is unclear. - Experience evaluating the financial impact of claims decisions, balancing contractual compliance, reimbursement outcomes, and long-term program integrity. - History of working with multiple TPA claim administrators and demonstrated ability to understand different claim reporting templates and to identify gaps in reports across partners. - Track record of serving as an escalation resource for complex claims issues, providing clear, well-reasoned recommendations to internal stakeholders. - Ability to collaborate effectively across functional departments including claims, underwriting, finance, legal, and operations without formal authority. - Experience mentoring or guiding other claims professionals through case review, technical coaching, or knowledge sharing. - Strong written and verbal communication skills, with the ability to clearly explain complex claims determinations to varied audiences. - Experience with Connexure, ESL Office software. Core Competencies - Stop Loss Claims Judgment: Applies consistent, defensible judgment in complex and high dollar stop loss claims through accurate interpretation of contract language, plan provisions, and medical documentation. - Technical Contract Interpretation: Demonstrates deep expertise in stop loss contracts and plan documents, including exclusions, limitations, aggregating specifics, lasers, and reimbursement thresholds. - Financial Impact Evaluation: Assesses the financial implications of claims decisions, balancing contractual compliance, reimbursement outcomes, and long-term program integrity. - Escalation & Decision Ownership: Serves as a senior escalation point for ambiguous or disputed claims, providing clear recommendations and owning decisions through resolution. - Comfort with Ambiguity: Operates effectively in non-standard claims scenarios where facts, documentation, or precedent are incomplete or conflicting. - Influence Through Expertise: Elevates claims quality and consistency through technical credibility, mentorship, and collaboration rather than positional authority. Compensation Pursuant to Washington regulation, the compensation range for this position is as stated and includes eligibility for performance-based bonuses. Washington Pay Range: $140,000 — $155,000 USD

• Lead engagement with NASTAD’s members as well as state and local health departments, serving as the primary point of contact and providing technical assistance and subject matter expertise on systems coordination and stakeholder engagement. • Contribute to the design, planning, and facilitation of meetings and in person convenings related to health systems collaboration, including internal planning sessions and stakeholder meetings. • Develop agendas and coordinate logistics for meetings to support cross-functional collaboration and project planning. • Develop content and deliver presentations for internal and external stakeholders, including funders, partners, and public health peers via webinars, office hours, and other virtual learning opportunities. • Track activities and key performance metrics using project management tools. • Manage program workplans by monitoring project milestones, tracking progress of activities, sending timely alerts for upcoming start and end dates, providing reminders to responsible parties, and delivering regular updates on accomplishments and status to ensure activities remain on schedule and objectives are met. • Develop tools, templates, guides, and other practical resources to support jurisdictions. • Oversee the process of disseminating tools and materials to our stakeholders, leveraging technology platforms, ensuring timely and accurate delivery of materials.

• Manage and monitor bankruptcy case progress, ensuring deadlines, filings, and hearings are handled on time. • Prepare, organize, and submit required legal documentation in accordance with court requirements. • Maintain accurate and up-to-date case records within the case management system. • Act as the main point of contact for clients, providing updates and responding to inquiries professionally. • Coordinate communication between clients, attorneys, courts, and trustees to ensure smooth case progression.