The Director, AI/ML Engineering - Claims Automation & Orchestration will lead the design and delivery of an AI-enabled orchestration capability for Optum Health claims platforms. This role will help connect automation across claims adjudication, eligibility, payment integrity, appeals and other related processes by coordinating agentic AI, deterministic automation, workflow, validation and observability into a scalable end-to-end execution model. This leader will stay hands-on technically while building and leading an engineering team focused on improving claims processing speed, quality, transparency and operational efficiency.
This role owns the shared orchestration layer and enabling standards; Success requires a solid technical leader who can operate across a complex, matrixed health care technology environment, influence senior stakeholders and translate emerging AI capabilities into production-ready solutions.
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.
Primary Responsibilities: - Lead the architecture and delivery of a cross-platform claims orchestration layer that coordinates work across claims systems, automation tools, AI services, workflow engines and human-in-the-loop processes
- Design a runtime routing model that determines when to use agentic AI, deterministic rules, workflow automation, RPA or manual escalation based on task type, confidence, risk and business requirements
- Establish durable execution patterns so multi-step and multi-day claims processes can persist state, recover from failures and resume work across multiple platforms
- Create common integration standards, reusable interfaces and task handoff patterns that allow platform teams to connect into a shared orchestration capability without duplicating work
- Build validation and control mechanisms including business-rule checks, output evaluation, confidence scoring, exception handling and human review for low-confidence, high-risk or high-dollar scenarios
- Instrument the orchestration layer with observability, telemetry and outcome reporting to monitor throughput, quality, adoption, exceptions, failures and business impact
- Partner across Claims Technology, Operations, Product, Compliance, Security, Enterprise Architecture and platform engineering teams to align the orchestration strategy with enterprise standards and business priorities
- Recruit, build, coach and lead a team of 5 to 20 AI/ML engineers, automation engineers and solution architects while remaining hands-on in technical design, prototyping and tool evaluation
- Define and communicate success measures, delivery milestones, risks and operating model needs to senior technology and business leadership
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 Qualifications: - 8+ years of experience in AI/ML engineering, automation engineering, platform engineering, software engineering or related technology leadership roles
- 5+ years of experience designing or delivering automation solutions across multiple systems, platforms or business processes
- 5+ years of experience establishing engineering standards, governance, observability, validation or control mechanisms for production technology solutions
- 5+ years of experience designing integration patterns, APIs, event-driven architectures, workflow orchestration, platform services or reusable engineering capabilities
- 3+ years of experience applying AI/ML, generative AI, agentic AI, workflow automation, rules engines, RPA or related technologies to improve business process execution
- 3+ years of experience building or leading engineering teams, including direct or matrixed leadership of engineers, architects or technical delivery teams
- 3+ years of experience partnering with business, product, operations, compliance, security and architecture stakeholders in a complex matrixed environment
- Experience partnering with business, product, operations, compliance, security, and architecture stakeholders in a complex matrixed environment
Preferred Qualifications: - Experience with health care payer operations, claims platforms, claims adjudication, payment integrity, appeals, provider data or related health care administrative processes
- Experience with platforms such as Facets or other enterprise claims systems
- Experience with agent orchestration frameworks, durable workflow engines, AI evaluation tools, observability platforms, BI/dashboarding tools or comparable technologies
- Experience scaling AI-enabled or automation-enabled capabilities from prototype to production in a regulated enterprise environment
- Experience communicating technical strategy, risks, tradeoffs and measurable outcomes to senior leadership
*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 $176,700 - $302,900 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.
