Head of AI-Enabled Facility Claims Review
Optum
Optum is seeking a Director of Product for Facility Claim Review, guiding a scalable portfolio of AI-enabled reimbursement solutions. You will own the product vision, roadmap, and performance, ensuring client value and market differentiation while working with AI/ML, analytics, and data science teams. You will lead cross‑functional teams across product, engineering, analytics, content, and operations to drive growth, improve accuracy, and financial outcomes for payers and providers nationwide. #J-18808-Ljbffr Optum
- ...UnitedHealth Group's Optum Insight seeks a Director of Product for Facilities Claims Review to guide a scalable, AI-enabled reimbursement accuracy solution. You will own vision, roadmap, and performance across in-market products with a strong client base, delivering measurable...FacilitiesClaimsRemote jobWork at office
$134.6k - $230.8k
...everyone through people-led, responsible AI while Caring. Connecting. Growing together. Shape the future of facility claim review by leading a scaled portfolio of established... ...and building the next generation of AI-enabled reimbursement accuracy solutions. The Director...FacilitiesClaimsRemote jobMinimum wageFull timeWork experience placementWork at officeLocal area- ...UnitedHealth Group is seeking a Director of Product for Facility Claim Review. You will own the product vision, roadmap, and performance for branch... ...Integrity. Lead cross-functional teams and partner with AI/ML, analytics, and data science to deliver scalable, measurable...FacilitiesClaimsRemote jobWork at office
$29 - $52 per hour
...together. The Clinical Review Clinician serves as a subject... ...and analyzing hospital facility bills. The clinical reviewer... ...comprehensive understanding of the claim review process including clinical... ...on the environment and enabling and delivering equitable care...FacilitiesClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaRemote work$22 - $26 per hour
...comprehensive suite of tech-enabled pharmacy services and a dedicated... ...customer bills and insurance claims in an accurate and timely... ...enrollment periods. Proactively review patient profiles, drug... ...discharge, and room changes for the facilities assigned.Process patient...FacilitiesClaimsFull timeTemporary workWork at officeFlexible hoursShift workWeekend work$72.8k - $130k
...relationships with ABA providers and facilities, monitoring their clinical... ...data and utilization/claims dataConduct audits of ABA programs... ...Care and/or Utilization Review experience in a Managed Care... ...impact on the environment and enabling and delivering equitable care...FacilitiesClaimsMinimum wageFull timeWork experience placementLocal areaRemote workMonday to FridayFlexible hours$134.6k - $230.8k
...From advanced data analytics and AI to cybersecurity, we use... ...improve Responsible AI and AI Review Board processesHelp identify vulnerabilities... ...healthcare systems including claims payment and call... ...impact on the environment and enabling and delivering equitable care...ClaimsMinimum wageFull timeWork experience placementLocal areaRemote work$176.7k - $302.9k
...From advanced data analytics and AI to cybersecurity, we use... ...Director, AI/ML Engineering - Claims Automation & Orchestration will... ...design and delivery of an AI-enabled orchestration capability for Optum... ...exception handling and human review for low-confidence, high-risk...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work- ...centric data driven insights and AI/ML solutions. Working in... ...mentoring data scientists and reviewing complex modeling approaches and... ...datasets and standards such as claims, EHR, ICD, CPT, SNOMED, FHIR,... ...impact on the environment and enabling and delivering equitable care...ClaimsLocal areaRemote work
$134.6k - $230.8k
...From advanced data analytics and AI to cybersecurity, we use... ...principal and senior data scientists, review technical designs and modeling... ...payment integrity, clinical, claims, compliance, legal, product,... ...impact on the environment and enabling and delivering equitable care...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work$24 - $43 per hour
...Coder/Acute Edits And Denials Claims Analyst Optum is a global... ...involving payer and compliance reviews ~ Other duties as assigned.... ...coding experience (hospital, facility, etc.) *All employees... ...impact on the environment and enabling and delivering equitable care...FacilitiesClaimsRemote jobHourly payMinimum wageFull timeWork experience placementLocal area$72.8k - $130k
...relationships with ABA providers and facilities, monitoring their clinical... ...data and utilization/claims data Conduct audits of ABA programs... ...Care and/or Utilization Review experience in a Managed Care... ...impact on the environment and enabling and delivering equitable care...FacilitiesClaimsMinimum wageFull timeWork experience placementLocal areaRemote workMonday to FridayFlexible hours$20 - $36 per hour
...data retrieval, analysis and claims processing. This position is... ...ancillary charts if needed Review provider documentation to determine... ...Emergency and Ancillary facility coding experience* ~ Must... ...impact on the environment and enabling and delivering equitable care...FacilitiesClaimsHourly payMinimum wageFull timeApprenticeshipWork experience placementWork at officeLocal areaRemote work$150k - $180k
...activity, including large capital projects and facility investments, creating an exciting... ...Operations and Engineering teams during project reviews, facility expansions, shutdowns,... ...matters. • Support workers' compensation, claims management, and return-to-work initiatives...FacilitiesClaimsFor contractorsWork at officeLocal areaFlexible hours$150k - $180k
...environmental leadership of all Miller Milling facilities and ensure compliance with corporate and... ...and Engineering teams during project reviews, facility expansions, shutdowns,... ...matters. Support workers' compensation, claims management, and return-to-work initiatives...FacilitiesClaimsFor contractorsH1bWork at officeLocal areaRemote workRelocation packageFlexible hours$164.6k - $282.2k
...From advanced data analytics and AI to cybersecurity, we use... ...analysis and design, coding, code review, testing and debugging,... ...tail after launch.Your work is enabling Optum clients with access to an... ...recognition applied to clinical notes, claims, faxes, referrals, prior...ClaimsMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote work- Optum is seeking a Director of AI/ML Engineering - Claims Automation & Orchestration to lead the design and delivery of an AI-enabled orchestration layer across claims platforms. You will connect automation, AI services, and workflow engines, while guiding a team of engineers...Claims
$124.7k - $187k
...technical resolution of material review board (MRB) items and non-... ...with engineers in other facilities or handing off processes to production... ...and sensor solutions enable the distribution of power, signal... ...or organizations falsely claiming to represent TE Connectivity....FacilitiesClaimsLocal area$114.32k - $171.48k
...of our semiconductor fab to enable our customers to progress from... ...production line. Deliver process reviews with the goal of... ...holidays, an on-site fitness facility, and an on-site self-serve market... ...receive a suspicious communication claiming to represent our company,...FacilitiesClaimsTemporary work- ...Product Manager to define and execute strategy for a Professional Claim Review product. You will own vision, roadmap, and performance,... ...value at scale and differentiating in the market. You’ll work with AI/ML, data science, and analytics teams to translate healthcare reimbursement...ClaimsRemote job
$88k - $98k
...support work papers on a monthly basis for facilities managed by VOANS. If you’re ready to... ...entries, generating the financial statements, reviewing financial statements, and reconciling... ...of A/P Invoices, Census, IBNR and Claims Paid. Provide daily support on financial...FacilitiesClaimsTemporary workWork at officeMonday to FridayFlexible hours$112.64k - $168.96k
...and supported. Lead account reviews, business planning sessions,... ...technologies, or related quantum-enabling technologies. Experience... ...holidays, an on-site fitness facility, and an on-site self-serve market... ...a suspicious communication claiming to represent our company, please...FacilitiesClaimsPermanent employmentContract workTemporary workWork at office$112.7k - $193.2k
...senior technical evaluation and AI governance expert within a... ...responsible for ensuring that AI-enabled clinical products and use... ...vendor vetting and clinical AI review. The role ensures that each use... ...assessments to validate performance claims, testing results, and evidence...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work- ...A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : Complete in as short as a few weeks to a few months...FacilitiesClaims
$123k - $163k
...solutions, backed by targeted risk control and claims services. Our employees are passionate... ...(CDMOs), laboratories, testing facilities, consultants, and other life sciences service... ...-life balance. Check out our Glassdoor reviews to see why people love working for Intact...FacilitiesClaimsFull timeContract workWork at officeFlexible hours- ...A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : * Complete in as short as a few weeks to a few months...FacilitiesClaims
$117.6k - $206k
...trusted reporting, reusable analytics, AI-enabled workflows, and future product capabilities... ...CI/CD, automated testing, code reviews, version control, monitoring, documentation... ...EHR, ERP, FHIR, HL7, Epic, Oracle Health, claims, provider, financial, operational, and clinical...ClaimsFull time$149.52k - $175.9k
...smarter financial decisions and enabling the communities we support to... ...We are seeking a Principal AI Engineer to help accelerate the... ...provided by law Review our full benefits available by... ...Security E-Verify program in all facilities located in the United States and...FacilitiesFull timeTemporary workWork experience placementLocal area3 days per week$105k - $132.5k
...environmental leadership of all Miller Milling facilities and ensure compliance with corporate and... ...or corrective measures. Serve on the Claims Team (with HR representative) to manage... ...and Engineering team with project reviews, capital planning, and contractor safety...FacilitiesClaimsFor contractorsH1bWork at officeLocal areaRemote workRelocation packageFlexible hours3 days per week$91.7k - $163.7k
...Integrity clinical operations using advanced AI/ML tooling to drive detection and... ...Databricks / ADB Experience with healthcare claim data Experience in transitioning projects... ...mitigating our impact on the environment and enabling and delivering equitable care that addresses...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work
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