Senior Capability Manager, Provider Capabilities
About The Position
The Senior Capability Manager, Provider Capabilities enables Optum Rx to acquire and use external clinical data for priority business needs. The role works closely with QHINs, clinical data exchange partners, and vendors to make data available and operationally usable across the organization and to evolve clinical data exchange capabilities as business needs and opportunities change. This role sets capability strategy, priorities, and roadmap; partners with business sponsors to define use cases, value, funding needs, and outcomes; and leads cross-functional teams and vendors from opportunity identification through implementation and continuous improvement. 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.
Requirements
- 5+ years of healthcare industry experience leading complex, cross-functional business, technology, data, or operational initiatives involving enterprise stakeholders and external vendors
- Experience with healthcare interoperability and clinical data exchange, including working knowledge of FHIR, NCPDP, HL7, health information networks, and/or related standards and solutions
- Experience defining capability strategies and roadmaps and translating business needs, value, risk, data, and governance considerations into executable plans and leadership-ready recommendations
Nice To Haves
- Experience with pharmacy, pharmacy benefit management (PBM), prior authorization, medication history, or related provider and pharmacy workflows
- Experience establishing healthcare data partnerships or managing vendors, clinical data suppliers, and/or vendor-specific operational processes
- Experience in Aha! and/or Rally
- Experience using AI tools and resources
- Knowledge of healthcare privacy, security, consent, permitted-use, and data-governance considerations
Responsibilities
- Own the strategy, roadmap, priorities, and ongoing evolution of Optum Rx clinical data exchange capabilities and business use cases
- Partner with business sponsors to prioritize opportunities, refine project scope and value, develop capital funding requests, and secure funding based on feasibility, risk, scalability, data availability, and enterprise alignment
- Translate healthcare business needs into clear capability requirements, data needs, interoperability approaches, success measures, and executable plans
- Lead cross-functional initiatives across Optum Rx lines of business, enterprise partners, technology teams, and external vendors, clarifying ownership, dependencies, decisions, and next steps
- Partner with architecture and engineering on solution design and delivery and with legal, procurement, privacy, security, compliance, and data experts on contracting, governance, regulatory, and data-use considerations
- Identify and manage appropriate networks, vendors, data suppliers, and exchange pathways to acquire data that is available and fit for intended business use cases, including requirements, contracting support, roadmap alignment, implementation, vendor-specific operational processes, and performance
- Communicate complex healthcare interoperability and data concepts in clear business language for technical, non-technical, and executive audiences
- Measure capability success based on data availability and operational usability across intended use cases, and identify opportunities to improve adoption, performance, and business outcomes
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
