Lead design and delivery of AI/ML solutions for touchless claims processing. Build, deploy, and monitor scalable models and automation, partner with SMEs and engineering, ensure compliance and production support, and identify new automation opportunities to improve adjudication accuracy and speed.
Requisition Number: 2339456
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.
Primary Responsibilities:
Required Qualifications:
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.
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.
Primary Responsibilities:
- Lead AI/ML solutions to enable touchless claims processing across CMC workflows
- Analyze complex claim patterns and design intelligent automation to reduce manual effort
- Build scalable models and rules that improve accuracy, speed, and adjudication quality
- Partner with SMEs, engineering, and operations to align automation with business goals
- Monitor model performance, ensure compliance, and provide continuous production support
- Drive innovation by identifying new automation opportunities that improve efficiency and outcomes
- 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 regards 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
Required Qualifications:
- Bachelor's degree or equivalent experience
- Solid experience working on ML frameworks, tensor flow
- Experience collaborating with SMEs, engineering, and operations to deliver automation
- Solid expertise in AI/ML engineering, model development, and automation frameworks
- Deep understanding of claims workflows, data patterns, and healthcare domain logic
- Hands on skills in Python, ML pipelines, cloud platforms, and scalable solution design
- Proven ability to analyze complex datasets and build accurate, reliable predictive models
- Proven solid problem solving, compliance awareness, and ownership of production ready solutions
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.
Top Skills
Tensorflow,Python,Ml Pipelines,Cloud Platforms,Automation Frameworks
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