Optum, Senior Director: Deep Understanding of Business Is the Key to Success

Rahul Goyal, Senior Director of Enterprise and Data Analytics at Optum, and President and CEO, Yubi Health Inc., speaks with Ernie Ostic, SVP of Products, Manta, about his role at Optum, defining the customer in the health care domain and understanding the cycle of businesses and customers.

Optum United is a data-centric organization with 3,000-plus people in the EDA sector managing and leveraging data to drive value and outcomes. Goyal states that the organization falls under the purview of United Health Group. “Whether it is customers, patient providers, or other health systems who work with us, I think that's at the core of the company, he adds. “In my role with EDA, I'm hugely focused on a few different areas, but the way I put it in my language would be, I help understand how to leverage data to create the value.”

An organization’s success lies in a deep understanding of the business domain and what they can achieve eventually, he continues. He also supports other critical business functions that influence drug pricing issues, such as enhancing the customer experience while driving members toward better drug cost alternatives, medication adherence, and building programs that positively affect the course of health care.

“I'm involved in a lot of those initiatives and work within EDA, with the core focus on a strong knowledge on business and driving value for the business,” he notes.

Goyal explains that United Health Group has both United Healthcare and Optum under its purview. United Healthcare is based on the payer market, which could be the commercial market or Medicare business. He refers to it as an international player.

In addition to the PBM Plus pharmacy business, Optum has care delivery organizations and provides technical support to peer organizations and health systems. 

Who is the customer in this arena?  “The definition of customer varies with each of these businesses,” Goya says. “And this fundamental thing is to look at it from each of these businesses’ standpoint or their customer standpoint. Whether it's a provider, a health system, another payer, or a consumer, these are all customers.”

He emphasizes that the organization should focus on generating value for them. He maintains that customers are those the company works with on a broad spectrum.

Goyal urges professionals to understand a business’s value chain and address the critical touchpoints. Consumers are at one touchpoint or another.

 “If you're supporting a health system, they, in turn, might be supporting their members. So, that is the long tail off of some of the cycle, but it's important to understand and see how it all plays out,” he says. “If a business is trying to cater to a consumer or an end-customer, and there are ways you can help them improve their operations or the product or services that they're offering, this, in turn, can impact their members.”

This also makes a difference in the speed customers are availing of products and services. Therefore, it is critical to understand the cycle, learn where the customers are in their journey and how the businesses can be supported for an overall positive consequence, he points out.

In conclusion, Goyal shares a retail analogy. “A lot of retail businesses have direct consumers, but they also might have other businesses they might be doing business with as wholesalers. They may have other products or services catering to other businesses working around the data and analytics or market insight, market research, and consuming information from you,” he says. “So, it all depends on where everybody is and how they can serve their best interest, and I think understanding that is critical.”