Remote Payer Systems & AI Transformation Director

Partners in Digital Health; Eden Prairie (MN); Remote; USD 135,000 - 231,000; Full time

Benefits offered by this job

Remote work flexibility

Job summary

UnitedHealth Group seeks a senior leader to drive payer platform transformation, AI-enabled operations and risk-informed delivery across complex healthcare programs. You will advise executives, shape architectures, and coordinate multi-vendor delivery teams across claims, enrollment, billing and benefits, ensuring measurable outcomes.

Remote work flexibility is available with in-office requirements in certain hubs; you will guide program governance, deliverables and executive communications

Qualifications

• 10+ years of relevant healthcare experience in health insurance, payer operations, healthcare technology or management consulting
• 5+ years of healthcare technology consulting experience supporting payer organizations
• 5+ years of program, project, engagement or team leadership with direct client-facing accountability
• 5+ years of experience with one major payer platform such as TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems or comparable core administrative system
• 1+ years of evaluating AI opportunities and risk for automation in healthcare or other regulated industries

Responsibilities

• Act as a trusted advisor across client business and technology organizations, building durable relationships with executives and delivery partners
• Assess current-state processes, architecture, data and operating models to identify transformation priorities
• Formulate technical solution architectures for payer platform implementation and modernization
• Lead or oversee implementations and modernization programs involving payer platforms such as TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry
• Guide work across claims, enrollment, billing, benefits, provider, pricing and customer service
• Own end-to-end technical delivery for complex payer transformation programs
• Establish delivery governance and executive reporting across multiple workstreams
• Manage scope, budget, schedule, resources, risks and changes
• Senior escalation point and recovery planning for delivery teams
• Lead multidisciplinary teams including architects, analysts and engineers
• Apply Agile, hybrid or structured delivery methods as appropriate
• Demonstrate knowledge of AI, generative AI, intelligent automation and analytics in healthcare
• Identify and prioritize practical AI opportunities across payer operations
• Develop AI-enabled transformation roadmaps and measurable adoption outcomes
• Participate in pursuits, solutioning and negotiations to grow accounts
• Contribute to annual sales objectives with growth targets
• Advance service offerings, reusable assets and thought leadership in payer transformation
• Lead creation and quality review of client-facing deliverables

Skills

Client relationships

Executive stakeholder engagement

Delivery leadership

Payer operations knowledge

AI opportunities assessment

Job description

UnitedHealth Group seeks a senior leader to drive payer platform transformation, AI-enabled operations and risk-informed delivery across complex healthcare programs. You will advise executives, shape architectures, and coordinate multi-vendor delivery teams across claims, enrollment, billing and benefits, ensuring measurable outcomes.

Remote work flexibility is available with in-office requirements in certain hubs; you will guide program governance, deliverables and executive communications