Overview
Optum is a global organisation 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities.
Come make an impact on the communities we serve as you help us advance health equity on a global scale.
Join us to start Caring.
Connecting.
Growing together.
As a Fortune 5 business, we're one of the world's leading healthcare companies.
There are no limits here on the resources you'll have or the challenges you'll encounter.
We have been supporting global healthcare systems from Ireland and the UK for more than 20 years, building a dynamic and diverse team of more than 2,100 talented individuals.
With a continued record of growth and stability, we\'re on the constant lookout for fresh talent to join our expanding teams.
Role Overview
As a Client Engagement Consultant (Encounter Submissions Consultant), you will be the primary point of contact for a portfolio of US-based health plan clients, managing a variety of tasks and data submissions to CMS.
You will act as the voice of the client within Optum, advocating for their needs and ensuring their data submissions—across Medicare, Medicaid, ACA, Chart Reviews, and Voids—are accurate and timely.
Your role is to build strong relationships, provide responsive support, and drive client success by achieving high submission acceptance rates and resolving issues efficiently.
You will act as a trusted advisor and advocate for your clients, helping them navigate the complexities of data submissions, resolve issues, and meet regulatory requirements.
Your goal is to drive client satisfaction, retention, and success by ensuring submission accuracy and timeliness—targeting over 99% acceptance rates.
Schedule
Full-time position with standard working hours of Monday – Friday, 9am – 5pm (must have flexibility across different time zones to manage client calls and during initial onboarding/training).
Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny office and telecommuting from a home-based office in a hybrid work model.
Primary Responsibilities
Serve as the liaison between assigned clients and internal Optum teams, representing the client's voice and priorities
Direct client facing support for MA Encounter Submissions to CMS with end-to-end accountability of client data
Understand the entire encounter submissions process and ensure to keep the client informed and provide guidance regarding CMS and Optum errors
Guide clients through the end-to-end encounter data submission process, including Medicare, Medicaid, ACA, Chart Reviews, and Voids
Monitor submission performance and proactively address errors or issues to ensure compliance with CMS standards
Provide timely, clear, and solution-oriented support to client inquiries and challenges
Collaborate with internal teams to escalate and resolve systemic issues or product enhancements
Lead client-specific projects and provide regular updates to both clients and senior leadership
Build and maintain strong, long-term relationships with clients to promote trust, retention, and growth
Ability to be have flexibility across different time zones to manage client calls and during initial onboarding/training
Additional Responsibilities
Analyze, review, forecast, and trend complex data
Present analysis and interpretation for operational and business review and planning
Support short and long term operational/strategic business activities through analysis
Develop recommended business solutions through research and analysis of data and business process and implement when appropriate
Conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning
Develop and implement effective/strategic business solutions through research and analysis of data and business processes
Work with less structured, more complex issues and serve as a resource to others
Required Qualifications
Bachelor's Degree (or higher) in Business, Finance, Health Administration, related field or equivalent experience
Proven experience in business/finance analysis, reporting or forecasting
Experience in direct client management – Customer Success, Account Management roles
Experience gathering requirements from the client/business and documenting
Experience with process improvement, project management, workflow, benchmarking and / or evaluation of business processes required
Intermediate level of proficiency with PC based software programs and automated database management systems required (Excel, Access, PowerPoint)
Preferred Qualifications
837 claim format experience
Healthcare Claim processing or health care related data required
Experience in an Agile work environment
Python programming
Working knowledge of relational databases, database structures
Working knowledge of SQL required & business reporting tools like Tableau, PowerBi, Quicksights or others
Working knowledge of Unix systems and commands
Soft Skills
Ability to perform well under pressure and multitask with little to no direction
Ability to communicate analysis including trends and opportunities to clients and the business in writing and verbally
Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data
Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application.
Proof will be required to support your application.
All telecommuters will be required to adhere to the UnitedHealth Group's Telecommuter Policy.
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 marginalised 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.
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law.
Optum is a drug-free workplace.
2025 Optum Services (Ireland) Limited.
All rights reserved.
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