UnitedHealth Group

Principal AI Program Manager, Appeals Innovation and Automation - Remote

UnitedHealth Group$91K — $163K *
US-AnywhereRemote in Cypress, CA
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in a relevant field such as Healthcare Administration, Computer Science, or Data Science.
  • Experience leading cross-functional programs with a focus on technology and operational changes.
  • Familiarity with generative AI, automation platforms, and workflow orchestration.
  • Understanding of responsible AI principles and risk management frameworks.
  • Strong communication and stakeholder management skills.

Responsibilities

  • Establish and manage the AI roadmap for the Appeals organization.
  • Identify AI opportunities to enhance quality, efficiency, and user experience.
  • Lead pilot programs and develop business cases for AI projects.
  • Design and deploy AI agents for Appeals and Grievance workflows.
  • Serve as the main point of contact for AI governance and compliance activities.

Benefits

  • Comprehensive benefits package including 401k contributions.
  • Incentive and recognition programs available.
  • Opportunities for professional development and career advancement.
  • Flexible remote work options with adherence to telecommuter policies.
Full Job Description
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.

Primary Responsibilities:

  • AI Strategy and Innovation
    • 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
  • AI Agent Development and Optimization
    • 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
  • Governance, Risk, and Regulatory Oversight
    • 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
  • Cross-Functional Leadership
    • 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
  • Change Management and Adoption
    • 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
  • Measurement and Continuous Improvement
    • 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


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:

  • 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


Preferred Qualifications:

  • 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


*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 $91,700 - $163,700 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.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ

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