[Hiring] Clinical Operations Director @UnitedHealth Group

Role Description

The Clinical Operations Director – Clinical AI will serve as a clinical strategy and solution enablement leader responsible for reviewing, indexing, and helping advance scalable AI solutions and support tools across inpatient, medical claims review, and reconsideration/appeals operations. This role will work cross collaboratively with product, technology enablement, technology, clinical operations, regulatory and key business stakeholders to translate clinical needs into prioritized AI opportunities, support ideators through the AIRB process, and provide clinical insight to AIRB governance discussions as initiatives are brought forward.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Review, index, and maintain visibility to emerging clinical AI ideas, use cases, and support tools across inpatient, MCR, regulatory and appeals to identify opportunities for scale, reuse, and enterprise alignment.
• Partner cross-functionally with product, technology enablement, technology teams, clinical operations, and key stakeholders to solution practical, compliant, and scalable AI-enabled workflows that support operational modernization.
• Understand AIRB intake, review, and prioritization pathways and support business ideators in preparing AI initiatives for review, including clarifying clinical value, operational impact, risk considerations, dependencies, and prioritization rationale.
• Serve as a clinical subject matter resource for AIRB board discussions, providing clinical context and answering questions related to utilization management, inpatient review, MCR, appeals, regulatory considerations, and member/provider impact.
• Develop executive-ready summaries, recommendations, and progress updates that communicate AI opportunity areas, prioritization status, solution readiness, and anticipated business impact.
• Resolve highly complex business problems that impact multiple areas of the organization.
• Develop executive-level updates and reports.
• Develop and execute measurable department-level business and affordability goals.
• Think creatively and curiously about business opportunities and communicate openly with leadership on strategies to operationalize change.
• Collect and review data to evaluate financial outcomes and present solutions to senior leaders to drive efficiencies.
• Aid in the development of operational budgets.
• Up to 10% travel.

Qualifications

• RN, PA, NP, Pharmacist, MD, or other active clinical licensure with solid understanding of utilization management.
• 5+ years of experience in a health plan, provider organization, payer-provider environment, or clinical operations setting supporting technology-enabled transformation.
• Experience evaluating AI, automation, analytics, clinical decision support, or workflow modernization opportunities for relevance, scalability, risk, and impact.
• Ability to translate clinical business problems into AI use cases, solution concepts, acceptance criteria, or measurable business outcomes.
• Working knowledge of responsible AI principles, governance expectations, model risk, privacy, compliance, and regulatory impacts.
• Ability to support AI intake and prioritization, including business rationale, value statement, workflow impact, dependencies, and AIRB readiness.
• 5+ years of professional experience partnering across product, strategy planning, technology enablement, technology delivery, clinical, operational, compliance, data, and senior stakeholder groups.
• Excellent communication skills, including ability to synthesize complex AI and clinical concepts into executive-level recommendations.

Preferred Qualifications

• Degree, certification, or formal training in health informatics, clinical informatics, data science, analytics, or a related field.
• Industry certification or training in AI, data analytics, agile delivery, process improvement, product management, project management, or change management.
• Experience supporting AI governance, AIRB submissions, responsible AI reviews, or enterprise intake/prioritization forums.
• Experience supporting CBA requirements, including value statements, impact assumptions, rationale, and documentation for prioritization, funding, and executive decision-making.
• Experience with generative AI, machine learning, predictive analytics, automation, clinical decision support, or AI-enabled workflow design.
• Ability to assess AI solution readiness, including intended use, clinical oversight, workflow integration, human-in-the-loop controls, measurement, and change management.

Skills You Will Develop

• Advance clinical AI strategy and solution intake practices across a highly matrixed enterprise.
• Evaluate AI use cases for clinical relevance, scalability, operational impact, and governance readiness.
• Manage emerging priorities, stakeholder needs, and solution development in a fast-paced environment.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

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.