At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized.
Ready to make a difference? Join us to start Caring. Connecting.
Growing together. The Clinical Operations Director - Clinical AI will serve as a clinical strategy and solution enablement leader responsible for reviewing, indexing, and helping advance scalable AI solutions and support tools across inpatient, medical claims review, and reconsideration/appeals operations. This role will work cross collaboratively with product, technology enablement, technology, clinical operations, regulatory and key business stakeholders to translate clinical needs into prioritized AI opportunities, support ideators through the AIRB process, and provide clinical insight to AIRB governance discussions as initiatives are brought forward.
You'll enjoy the flexibility to work remotely * from anywhere within the U. S. as you take on some tough challenges. Primary
Review, index, and maintain visibility to emerging clinical AI ideas, use cases, and support tools across inpatient, MCR, regulatory and appeals to identify opportunities for scale, reuse, and enterprise alignment Partner cross-functionally with product, technology enablement, technology teams, clinical operations, and key stakeholders to solution practical, compliant, and scalable AI-enabled workflows that support operational modernization Understand AIRB intake, review, and prioritization pathways and support business ideators in preparing AI initiatives for review, including clarifying clinical value, operational impact, risk considerations, dependencies, and prioritization rationale Serve as a clinical subject matter resource for AIRB board discussions, providing clinical context and answering questions related to utilization management, inpatient review, MCR, appeals, regulatory considerations, and member/provider impact Develop executive-ready summaries, recommendations, and progress updates that communicate AI opportunity areas, prioritization status, solution readiness, and anticipated business impact Resolve highly complex business problems that impact multiple areas of the organization Develop executive-level updates and reports Develop and execute measurable department-level business and affordability goals Think creatively and curiously about business opportunities and communicate openly with leadership on strategies to operationalize change Collect and review data to evaluate financial outcomes and present solutions to senior leaders to drive efficiencies Aid in the development of operational budgets Up to 10% travel 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
RN, PA, NP, Pharmacist, MD, or other active clinical licensure with solid understanding of utilization management 5+ years of experience in a health plan, provider organization, payer-provider environment, or clinical operations setting supporting technology-enabled transformation Experience evaluating AI, automation, analytics, clinical decision support, or workflow modernization opportunities for relevance, scalability, risk, and impact Ability to translate clinical business problems into AI use cases, solution concepts, acceptance criteria, or measurable business outcomes Working knowledge of responsible AI principles, governance expectations, model risk, privacy, compliance, and regulatory impacts Ability to support AI intake and prioritization, including business rationale, value statement, workflow impact, dependencies, and AIRB readiness 5+ years of professional experience partnering across product, strategy planning, technology enablement, technology delivery, clinical, operational, compliance, data, and senior stakeholder groups Excellent communication skills, including ability to synthesize complex AI and clinical concepts into executive-level recommendations
Degree, certification, or formal training in health informatics, clinical informatics, data science, analytics, or a related field Industry certification or training in AI, data analytics, agile delivery, process improvement, product management, project management, or change management Experience supporting AI governance, AIRB submissions, responsible AI reviews, or enterprise intake/prioritization forums Experience supporting CBA requirements, including value statements, impact assumptions, rationale, and documentation for prioritization, funding, and executive decision-making Experience with generative AI, machine learning, predictive analytics, automation, clinical decision support, or AI-enabled workflow design Ability to assess AI solution readiness, including intended use, clinical oversight, workflow integration, human-in-the-loop controls, measurement, and change management Skills You Will Develop: Advance clinical AI strategy and solution intake practices across a highly matrixed enterprise Evaluate AI use cases for clinical relevance, scalability, operational impact, and governance readiness Manage emerging priorities, stakeholder needs, and solution development in a fast-paced environment *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 $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.
Job posting may come down early due to volume of applicants. 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.