Principal AI Program Manager, Appeals Innovation and Automation - Remote

Requisition Number: 2383000
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 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.
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.