Remote Chief, Clinical AI Innovation & Utilization

University of Minnesota School of Nursing; Minnetonka (MN); Hybrid; USD 387,000 - 580,000; Full time

Job summary

UnitedHealthcare is seeking a Senior Medical Director, Clinical AI Innovation and Performance to lead clinical AI model training, testing and surveillance for Utilization Management. The role centers on guideline interpretation, evidence-based criteria and scalable clinical decision support across enterprise operations.

You will collaborate with UCS AI leadership, Medical Policy, and care management teams while guiding annotation, training and governance for AI-enabled UM processes.

Qualifications

• MD or DO with active/unrestricted U.S. medical licensure.
• Board certification in ABMS/AOBMS clinical specialty.
• Significant experience in utilization management and coverage interpretation.
• Demonstrated experience with InterQual criteria and UM operations at scale.
• Ability to lead across clinical, operational and technical teams.

Responsibilities

• Lead clinical annotation and analysis supporting LLM-based UM decision support.
• Oversee clinical review ensuring accurate interpretation of UM criteria by LLMs.
• Provide governance for AI-enabled UM workflows and clinical decisions.
• Collaborate with Medical Policy, CARES, UM Operations and AI/data science teams.
• Guide guideline clarification and criteria enhancements for enterprise-wide use.

Skills

Utilization management

InterQual criteria

Clinical leadership

Education

MD or DO with U.S. medical licensure

Tools

InterQual

Job description

UnitedHealthcare is seeking a Senior Medical Director, Clinical AI Innovation and Performance to lead clinical AI model training, testing and surveillance for Utilization Management. The role centers on guideline interpretation, evidence-based criteria and scalable clinical decision support across enterprise operations.

You will collaborate with UCS AI leadership, Medical Policy, and care management teams while guiding annotation, training and governance for AI-enabled UM processes.