Associate Director - AI Transformation - Remote

UnitedHealth Group•Eden Prairie, MN

19h•$112,700 - $193,200•Remote

About The Position

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. UMR, the largest Third-Party Administrator (TPA), a UnitedHealthcare company, is seeking an Associate Director – AI Transformation to lead business analysis and delivery governance across a portfolio of Agentic AI solutions within UMR Operations. This role will provide strategic leadership for requirements management, solution alignment, and cross-functional execution for multiple AI-enabled products focused on improving claim adjudication efficiency, payment integrity, and operational accuracy. The Associate Director will own the operating model for requirements, AI rule governance, and stakeholder coordination across technology, product, clinical, pricing, network, compliance, and payment integrity teams. This leader will supervise a team of consultants responsible for translating complex healthcare claims logic into AI-driven workflows, decision rules, and operational capabilities. 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

8+ years of experience in healthcare payer operations, healthcare consulting, or healthcare technology delivery
5+ years of experience in healthcare claims operations including adjudication, payment integrity, or benefits administration
3+ years of experience leading business analysis teams or complex transformation initiatives
Experience leading cross-functional initiatives involving product, IT, operations, and compliance teams
Demonstrated experience managing enterprise-level requirements strategy and governance
Deep understanding of healthcare claims processing including eligibility and benefits, coding edits, modifiers, coordination of benefits (COB), authorization rules, bundling/unbundling, contract pricing, and adjustments
Solid stakeholder management and executive communication skills

Nice To Haves

Experience implementing AI, automation, or decision intelligence solutions within healthcare payer operations
Experience with payment integrity programs, claims editing platforms, or healthcare pricing systems
Experience working with large payer organizations or third-party administrators
Knowledge of Agentic AI frameworks, prompt design, or rule-based automation in operational workflows
Familiarity with Agile or product-based delivery models in enterprise technology environments

Responsibilities

Lead business analysis strategy and governance across a multi-product Agentic AI portfolio supporting claims operations (First Pass Adjudication, High Dollar Claims, Payment Integrity, Rework Automation, Reverse Quality Engine)
Establish and standardize requirements frameworks, documentation standards, traceability models, and acceptance criteria across all AI initiatives
Align AI solution design with business objectives by collaborating with Product, IT Architecture, Data Science, Clinical, Pricing, Network, Compliance, and Payment Integrity stakeholders
Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance
Manage cross-workstream dependencies, integration points, and delivery sequencing across multiple AI initiatives
Implement governance for AI rule libraries, prompt frameworks, and reusable decision components to ensure consistency and scalability across products
Supervise and mentor a team of business analysis consultants responsible for detailed requirements elaboration and product delivery support
Drive portfolio-level consistency and reuse of operational rules and AI decision patterns to accelerate implementation and reduce redundant build efforts
Partner with program leadership to track value realization including improvements in cycle time, auto-adjudication rate, payment accuracy, and rework reduction
Support stakeholder governance, executive reporting, and operational alignment across business and technology teams
Ensure audit readiness, compliance traceability, and documentation for AI-enabled decision processes in claims operations