Director, Payer Platform Transformation & AI Solutions

UnitedHealth Group; Eden Prairie (MN); Hybrid; USD 135,000 - 231,000; Full time

Job summary

Optum Insight, part of UnitedHealth Group, seeks a senior payer-operations leader to drive complex platform transformations, AI-enabled initiatives and cross-functional delivery across payer platforms. Remote work is allowed nationwide with in-office four days weekly in Minneapolis or Washington, D.C.

area requirements for certain roles may apply. You will own end-to-end delivery, governance and stakeholder alignment across diverse teams, ensuring outcomes, quality and client satisfaction in

Qualifications

• 10+ years of healthcare experience across payer operations and consulting.
• 5+ years in healthcare technology consulting for payers.
• 5+ years leading programs or teams with client-facing accountability.
• 5+ years with major payer platforms (TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems).
• 1+ year evaluating AI opportunities in healthcare or regulated industries.

Responsibilities

• Act as trusted advisor across client business and technology orgs, building durable relationships with executives and delivery partners.
• Assess current-state processes, applications, architecture, data, integration patterns and operating models to identify transformation priorities.
• Formulate technical solution architectures for payer platform implementations, migrations, modernization, optimization and integration.
• Lead or oversee implementations and modernization programs involving core administrative payer platforms such as TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems or comparable platforms.
• Own end-to-end delivery for complex payer system transformation programs with outcomes, quality and client experience accountability.
• Establish delivery governance, integrated plans, decision rights, architecture oversight, and executive reporting across workstreams and vendors.
• Manage scope, budget, schedule, resources, risks and changes; address delivery variance and facilitate fact-based decisions.
• Lead multidisciplinary teams including architects, analysts, engineers and change leaders, applying Agile or hybrid delivery methods.
• Identify and prioritize AI opportunities across claims, enrollment, customer service and provider data.
• Help clients develop AI-enabled transformation roadmaps and measurable adoption outcomes.
• Participate in pursuits, solutioning, and proposals; expand accounts by mapping client needs to capabilities.
• Contribute to sales objectives, including generating new account growth and revenue responsibility.
• Advance service offerings and thought leadership related to payer platform transformation and AI-enabled operations.
• Lead creation and quality review of client-facing deliverables and executive materials.

Skills

Healthcare experience

Healthcare technology consulting

Program leadership

Payer platform knowledge

AI opportunities evaluation

Tools

TriZetto Facets

HealthRules Payer

QNXT

Epic Tapestry

ikaSystems

Job description

Optum Insight, part of UnitedHealth Group, seeks a senior payer-operations leader to drive complex platform transformations, AI-enabled initiatives and cross-functional delivery across payer platforms. Remote work is allowed nationwide with in-office four days weekly in Minneapolis or Washington, D.C.

area requirements for certain roles may apply. You will own end-to-end delivery, governance and stakeholder alignment across diverse teams, ensuring outcomes, quality and client satisfaction in