AI Transformation Product Manager - Healthcare Ops

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

UMR, the largest Third-Party Administrator (TPA), a United Healthcare company, is seeking an Senior Product Manager - AI Transformation to lead business analysis and delivery governance across a portfolio of Agentic AI solutions within UMR Operations. This role will provide strategic leadership for requirements management, solution alignment, and cross-functional execution for multiple AI-enabled products focused on improving claim adjudication efficiency, payment integrity, and operational accuracy.

The Senior Product Manager will own the operating model for requirements, AI rule governance, and stakeholder coordination across technology, product, clinical, pricing, network, compliance, and payment integrity teams. This leader will partner with a team of consultants responsible for translating complex healthcare claims logic into AI-driven workflows, decision rules, and operational capabilities.

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:

• Lead business analysis strategy and governance across a multi-product Agentic AI portfolio supporting claims operations (First Pass Adjudication, High Dollar Claims, Payment Integrity, Rework Automation, Reverse Quality Engine)
• Establish and standardize requirements frameworks, documentation standards, traceability models, and acceptance criteria across all AI initiatives
• Align AI solution design with businessobjectivesby collaborating with Product, IT Architecture, Data Science, Clinical, Pricing, Network, Compliance, and Payment Integrity stakeholders
• Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance
• Manage cross-workstream dependencies, integration points, anddeliverysequencing across multiple AI initiatives
• Implement governance for AI rule libraries, prompt frameworks, and reusable decision components to ensure consistency and scalability across products
• Partner with a team of capability manager responsible for detailedrequirementselaboration and product delivery support
• Lead through influence to drive portfolio-level consistency and reuse of operational rules and AI decision patterns to accelerate implementation and reduce redundant build efforts
• Partner with program leadership to track value realization including improvements in cycle time, auto-adjudication rate, payment accuracy, and rework reduction
• Support stakeholder governance, executive reporting, and operational alignment across business and technology teams
• Ensure audit readiness, compliance traceability, and documentation for AI-enabled decision processes in claims operations

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:

• 8+ years of experience in healthcare payer operations, healthcare consulting, or healthcare technology delivery
• 5+ years of experience in healthcare claims operations including adjudication, payment integrity, or benefits administration
• 3+ years of experience leading business analysis teams or complex transformation initiatives
• Experience leading cross-functional initiatives involving product, IT, operations, and compliance teams
• Experience in creating structured strategies and solution artifacts (e.g., use case briefs, process flows) and integrating models into existing products/capabilities
• Experience in PDLC and AIDLC while leveraging modern product management tools - Aha!, JIRA, FIGMA, MIRO, Git Hub, etc.
• Demonstrated experience managing enterprise-level requirements strategy and governance
• Demonstrated experience defining or contributing to AI use case strategy, including problem framing, value hypotheses, and measurable success metrics
• Deep understanding of healthcare claims…