National Medical Director, Clinical AI Innovation (Remote)

UnitedHealthcare; Minnetonka (MN); Remote; USD 250,000 - 350,000; Full time

Job summary

UnitedHealthcare is seeking a National Medical Director, Clinical AI Innovation and Performance, to lead clinical annotation, model training, and surveillance for UM criteria across enterprise operations. You will drive evidence-based enhancements, coordinate with Medical Policy and AI teams, and ensure safe, effective care at scale.

Remote within the United States, with cross-functional leadership responsibilities.

Responsibilities

• Maintain deep expertise in InterQual criteria, evidence framework, and decision logic
• Ensure consistent, accurate interpretation of InterQual criteria across services, settings, and levels of care
• Lead guideline clarification, customization, and enhancement for clinical clarity and operational efficiency
• Develop and approve evidence-based enhancements or supplemental criteria aligned with medical policy
• Collaborate with Medical Policy and evidence teams to ensure policy translates into UM criteria
• Oversee clinical annotation and testing supporting LLM-based UM decision support
• Provide clinical oversight during annotator disagreements and complex training data scenarios
• Participate in AI lifecycle governance, including training, validation, shadow mode, and production deployment
• Direct clinical annotators and UM analysts, coordinating with Policy, CARES, and AI/data science teams
• Ensure insights from production and audits inform guideline clarification and ongoing AI model improvements

Job description

UnitedHealthcare is seeking a National Medical Director, Clinical AI Innovation and Performance, to lead clinical annotation, model training, and surveillance for UM criteria across enterprise operations. You will drive evidence-based enhancements, coordinate with Medical Policy and AI teams, and ensure safe, effective care at scale.

Remote within the United States, with cross-functional leadership responsibilities.