Product Capability Manager - AI Transformation, UMR - Remote

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

UMR is seeking Product Capability Manager - AI Transformation to support the design and implementation of Agentic AI solutions transforming healthcare claims operations. These roles will work closely with product leaders, technology teams, and domain experts to translate complex claims processing rules into clear business requirements, AI prompts, decision logic, and operational workflows. The Product Capability Manager will play a critical role in enabling AI-driven capabilities that improve claim adjudication efficiency, payment integrity outcomes, and operational accuracy across multiple AI products.

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

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Partner with stakeholders to identify and prioritize AI use cases based on business value
• Drive capability vision, strategy, priority and roadmap and engage appropriate enterprise-wide stakeholders to enable awareness and alignment. Own capability backlog and feature/use case prioritization decisions
• Define success metrics and measure product and capability performance and own outcomes
• Lead product lifecycle management from ideation through deployment and enhancement
• Manage the capability and its usage across businesses across the lifecycle, using a defined development process. Drive adoption and value realization of AI-enabled capabilities
• Lead detailed requirements gathering and analysis for AI-enabled claims operations initiatives
• Translate healthcare claims policies, SOPs, and operational guidelines into structured requirements, decision rules, and AI prompts
• Collaborate with Product, IT, Data Science, UX, Clinical, Pricing, and Payment Integrity stakeholders to design AI-assisted claims workflows
• Convert complex claims logic (eligibility/benefits, coding edits, modifiers, COB, authorization rules, contract pricing, bundling/unbundling, and recoupment logic) into testable system requirements
• Develop detailed user stories, functional specifications, acceptance criteria, and traceability documentation
• Support development and refinement of AI agent prompts, decision logic, and rule configurations used in claims automation workflows
• Participate in solution design sessions to ensure business logic is accurately represented in system functionality
• Support testing, validation, and operational readiness of AI-enabled claims capabilities
• Document business processes, operational workflows, and system interactions for new AI-driven capabilities
• Collaborate with program leadership to ensure alignment across multiple Agentic AI products and maintain consistency in requirements standards
• Serve as the capability champion and apply deep expertise to credibly represent, manage and engage with business(es)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of experience in healthcare payer operations, healthcare consulting, or healthcare technology delivery
• 3+ years of experience working with healthcare claims processing including eligibility/benefits, claims edits, coding logic, COB, or pricing
• Experience writing business requirements, user stories, functional specifications, and acceptance criteria
• Experience collaborating with cross-functional teams including IT, product management, and operations stakeholders
• Experience defining or contributing to AI use case strategy, including problem framing, value hypotheses, and measurable success metrics
• Exp…