Principal AI Program Manager, Appeals Innovation and Automation - Remote

UnitedHealth Group•Tampa, FL

9d•$91,700 - $163,700•Remote

About The Position

The Principal AI Program Manager will lead the identification, governance, development, implementation, and scaling of Artificial Intelligence solutions across the Appeals organization. This role serves as the bridge between business operations, clinical leadership, technology teams, legal, compliance, privacy, security, and enterprise governance to ensure the responsible deployment of AI capabilities that improve quality, efficiency, consistency, and user experience. The ideal candidate will possess deep expertise in AI agents, workflow automation, generative AI, and healthcare operations, with a proven ability to translate business challenges into AI-enabled solutions. This individual will drive the full lifecycle of AI initiatives, from opportunity assessment and business case development through governance approval, implementation, adoption, and ongoing optimization. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Bachelor's degree in Healthcare Administration, Nursing, Computer Science, Engineering, Information Systems, Data Science, or related field
Experience leading complex cross-functional programs involving technology and operational transformation
Experience with generative AI, AI agents, automation platforms, workflow orchestration, or intelligent document processing
Solid understanding of responsible AI principles, governance frameworks, and risk management
Demonstrated excellent communication, stakeholder management, and executive presentation skills
Demonstrated ability to lead initiatives from strategy through implementation and adoption

Nice To Haves

Project or product management certification
Healthcare experience, particularly within Appeals, Utilization Management, Clinical Operations, Claims, Revenue Cycle, or Regulatory Operations
Experience with Microsoft Copilot Studio, Azure AI, Power Automate, Microsoft Graph, custom connectors, retrieval-augmented generation, and agentic AI frameworks
Experience presenting initiatives to governance boards and obtaining regulatory, compliance, or risk approvals
Experience with document processing, OCR, knowledge management, search technologies, and workflow automation
Familiarity with healthcare data privacy, security, and regulatory requirements

Responsibilities

Establish and maintain the Appeals AI roadmap and portfolio of initiatives
Identify opportunities to improve quality, efficiency, consistency, turnaround times, and user experience through AI and automation
Evaluate emerging AI technologies, agent frameworks, and automation platforms for applicability within Appeals operations
Lead pilot programs, proofs of concept, and innovation initiatives
Develop business cases, return-on-investment analyses, and implementation strategies for AI projects
Design, build, test, and deploy AI agents supporting Appeals and Grievance workflows
Collaborate with technology teams to develop custom AI agents, connectors, retrieval solutions, and workflow automations
Establish evaluation methodologies and accuracy testing frameworks
Continuously refine prompts, workflows, training data, retrieval strategies, and agent configurations to improve performance
Develop monitoring and feedback loops to ensure sustained accuracy and reliability
Serve as the primary owner of AI governance activities within Appeals
Develop documentation and presentations required for Artificial Intelligence Review Board (AIRB) and governance committee approvals
Partner with Legal, Compliance, Privacy, Information Security, and Risk Management teams to ensure responsible implementation
Ensure AI solutions adhere to corporate policies, healthcare regulations, and responsible AI standards
Maintain audit-ready documentation supporting validation, transparency, monitoring, and risk mitigation activities
Act as the primary AI subject matter expert for Appeals Operations
Partner with operational leaders, medical directors, nurses, analysts, product teams, architects, engineers, and vendors
Translate business requirements into technical specifications and implementation plans
Coordinate efforts across multiple business units and enterprise technology organizations
Facilitate stakeholder alignment and executive communication
Develop AI adoption strategies and organizational change management plans
Create training materials, educational resources, and best practices for users
Promote responsible and effective use of AI-enabled solutions
Build organizational trust through transparent evaluation and measurable outcomes
Support production deployments and enterprise scaling efforts
Define key performance indicators and success metrics for AI initiatives
Measure impacts on quality, accuracy, productivity, consistency, cost, and user satisfaction
Deliver executive reporting and outcome analyses
Identify opportunities for continuous improvement and expansion of AI capabilities