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 ...
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 ...
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 ...
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 ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance * Manage cross-workstream dependencies ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance * Manage cross-workstream dependencies ...
Property Field Claims Adjuster (Bemidji, MN)
Bemidji, MN · On-site +1
$57K - $94K/yr
You will proactively provide all parties with the claim process and status as appropriate; answer ... Construction background or familiarity and experience with Xactimate. #LI-Remote Additional ...
Property Field Claims Adjuster (Bemidji, MN)
Bemidji, MN · On-site +1
$57K - $94K/yr
You will proactively provide all parties with the claim process and status as appropriate; answer ... Construction background or familiarity and experience with Xactimate. #LI-Remote Additional ...
Property Field Claims Adjuster (Bemidji, MN)
Bemidji, MN · On-site +1
$57K - $94K/yr
You will proactively provide all parties with the claim process and status as appropriate; answer ... Construction background or familiarity and experience with Xactimate. #LI-Remote Additional ...
Property Field Claims Adjuster (Bemidji, MN)
Bemidji, MN · On-site +1
$57K - $94K/yr
You will proactively provide all parties with the claim process and status as appropriate; answer ... Construction background or familiarity and experience with Xactimate. #LI-Remote Additional ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance * Manage cross-workstream dependencies ...
Senior Product Manager - AI Transformation, UMR - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Oversee translation of complex claims processing logic into AI-driven rules, prompts, and decision frameworks ensuring regulatory and contractual compliance * Manage cross-workstream dependencies ...
Epic Denials Management Operator
Minneapolis, MN · Remote
$18.75 - $25/hr
... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...
Epic Denials Management Operator
Minneapolis, MN · Remote
$18.75 - $25/hr
... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...
Senior Claim Manager - GL/E&S Casualty and Construction Liability (Hybrid or Remote)
Minneapolis, MN · On-site +1
$173K - $204K/yr
This position will join our Claims team based in our Denver, CO or Plymouth, MN offices on a hybrid ... process. The typical base salary range for this position is: $159,000 - $200,000, based on the ...
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Senior Claim Manager - GL/E&S Casualty and Construction Liability (Hybrid or Remote)
Minneapolis, MN · On-site +1
$173K - $204K/yr
This position will join our Claims team based in our Denver, CO or Plymouth, MN offices on a hybrid ... process. The typical base salary range for this position is: $159,000 - $200,000, based on the ...
Administrative Assistant - REMOTE - Little Rock, Arkansas, United States
Rochester, MN · Remote
$17/hr
Ensures that claims are handled in a prompt manner based on the date, time and order received ... process. Unsolicited Outreach Statement - Recruitment Agencies We will not accept unsolicited ...
Administrative Assistant - REMOTE - Little Rock, Arkansas, United States
Rochester, MN · Remote
$17/hr
Ensures that claims are handled in a prompt manner based on the date, time and order received ... process. Unsolicited Outreach Statement - Recruitment Agencies We will not accept unsolicited ...
Disability Assistant
Minneapolis, MN · Remote
Informs claimants of documentation required to process claims, required timeframes, and claims ... Associate's Degree. #Remote #telushealthjobs #FMLA #LI-JG1 A bit about us We're a people-focused ...
Disability Assistant
Minneapolis, MN · Remote
Informs claimants of documentation required to process claims, required timeframes, and claims ... Associate's Degree. #Remote #telushealthjobs #FMLA #LI-JG1 A bit about us We're a people-focused ...
Insurance Specialist (Remote) - Payment Posting & Medical Billing - Central Time Zone or Pacific ...
Sartell, MN · Remote
$18 - $21/hr
This role ensures insurance claims are accurately reviewed, followed up on, and resolved to support ... Process adjustments in accordance with payer contracts, client requirements, and company policies
New
Insurance Specialist (Remote) - Payment Posting & Medical Billing - Central Time Zone or Pacific ...
Sartell, MN · Remote
$18 - $21/hr
This role ensures insurance claims are accurately reviewed, followed up on, and resolved to support ... Process adjustments in accordance with payer contracts, client requirements, and company policies
New
Insurance Specialist (Remote) - Eastern & Central Time Zones
Sartell, MN · Remote
$18 - $21/hr
Insurance Specialists are highly focused on the resolution of insurance processing errors and ... You will utilize your expertise in patient billing, claims submission, and payer guidelines ...
Insurance Specialist (Remote) - Eastern & Central Time Zones
Sartell, MN · Remote
$18 - $21/hr
Insurance Specialists are highly focused on the resolution of insurance processing errors and ... You will utilize your expertise in patient billing, claims submission, and payer guidelines ...
Insurance Specialist (Remote) - Eastern & Central Time Zones
Sartell, MN · On-site +1
$18 - $21/hr
Insurance Specialists are highly focused on the resolution of insurance processing errors and ... You will utilize your expertise in patient billing, claims submission, and payer guidelines ...
Insurance Specialist (Remote) - Eastern & Central Time Zones
Sartell, MN · On-site +1
$18 - $21/hr
Insurance Specialists are highly focused on the resolution of insurance processing errors and ... You will utilize your expertise in patient billing, claims submission, and payer guidelines ...
... remote Worker's Compensation Bill Review Systems Analyst. The Bill Review Process Analyst is ... in bill/claims processing systems in the Workers Compensation industry across multiple ...
... remote Worker's Compensation Bill Review Systems Analyst. The Bill Review Process Analyst is ... in bill/claims processing systems in the Workers Compensation industry across multiple ...
Manager of Plan Build and Benefits Configuration
Minneapolis, MN · On-site +1
$95K - $125K/yr
This role ensures accuracy, compliance, and operational excellence across all claims processes ... Ability to delegate and adapt to changing circumstances and unexpected challenges in remote work ...
Manager of Plan Build and Benefits Configuration
Minneapolis, MN · On-site +1
$95K - $125K/yr
This role ensures accuracy, compliance, and operational excellence across all claims processes ... Ability to delegate and adapt to changing circumstances and unexpected challenges in remote work ...
Summary #LI-Remote The AD, Access & Reimbursement, NPS CV is in Minneapolis, MN geography. This is ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Summary #LI-Remote The AD, Access & Reimbursement, NPS CV is in Minneapolis, MN geography. This is ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
... claims processing, IT, or facility contract configuration * 5 years of experience of working with healthcare regulations, compliance requirements, and reimbursement methodologies (includes DRG, APC ...
... claims processing, IT, or facility contract configuration * 5 years of experience of working with healthcare regulations, compliance requirements, and reimbursement methodologies (includes DRG, APC ...
Summary #LI-Remote The AD, Access & Reimbursement, NPS CV is in Minneapolis, MN geography. This is ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Summary #LI-Remote The AD, Access & Reimbursement, NPS CV is in Minneapolis, MN geography. This is ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Access & Reimbursement Manager (ARM) Immunology - MINNEAPOLIS, MN
Minneapolis, MN · Remote
$138K - $257K/yr
This is a remote & field-based role that covers the following but not limited to: MINNEAPOLIS ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Access & Reimbursement Manager (ARM) Immunology - MINNEAPOLIS, MN
Minneapolis, MN · Remote
$138K - $257K/yr
This is a remote & field-based role that covers the following but not limited to: MINNEAPOLIS ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Access & Reimbursement Manager (ARM) Immunology - MINNEAPOLIS, MN
Saint Paul, MN · Remote
$138K - $257K/yr
This is a remote & field-based role that covers the following but not limited to: MINNEAPOLIS ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Access & Reimbursement Manager (ARM) Immunology - MINNEAPOLIS, MN
Saint Paul, MN · Remote
$138K - $257K/yr
This is a remote & field-based role that covers the following but not limited to: MINNEAPOLIS ... claims processing, reimbursement, and integration of manufacturer support programs into a range of ...
Remote Claims Processor Evening information
What is the difference between Remote Claims Processor Evening vs Remote Claims Processor Night?
| Aspect | Remote Claims Processor Evening | Remote Claims Processor Night |
|---|---|---|
| Work Hours | Typically 4 PM to 12 AM | Typically 12 AM to 8 AM |
| Certifications | Same certifications required | Same certifications required |
| Work Environment | Remote, collaborative with daytime teams | Remote, quieter, less team interaction |
| Industry Usage | Common in insurance and healthcare sectors |
The main difference between Remote Claims Processor Evening and Night roles lies in their work hours. Evening shifts typically run from late afternoon to late evening, while Night shifts cover overnight hours. Both roles require similar certifications and work in remote environments within the insurance and healthcare industries. Your choice depends on your preferred working hours and lifestyle.
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Product Capability Manager - AI Transformation, UMR - Remote
Eden Prairie, MN • On-site, Remote
Full-time
Retirement
Posted 12 days ago
UnitedHealth Group rating
7.6
Based on 146 frontline employees who took The Breakroom Quiz
188th of 887 rated healthcare providers
Job description
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
- 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, GitHub, etc.
- Proven solid analytical skills with the ability to translate complex operational processes into structured requirements
- Proven solid written and verbal communication skills
- Proven ability to design or operate within AI intake and prioritization frameworks, including evaluating initiatives based on business impact, feasibility, and adoption potential
Preferred Qualifications:
- Experience supporting AI, automation, or advanced analytics initiatives within healthcare payer operations
- Experience translating policy or clinical guidelines into operational or system rules
- Experience working with large payer organizations or TPAs
- Experience evaluating and supporting legal, compliance, and risk considerations for AI solutions, including areas such as model governance, responsible AI, and regulatory alignment
- Exposure to prompt engineering, rule engines, or decision automation platforms
- Knowledge of claims adjudication systems, payment integrity platforms, or healthcare pricing tools
- Working knowledge of production AI systems, including MLOps or deployment considerations
- Familiarity with Agile development methodologies and product delivery frameworks
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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About UnitedHealth Group
Sourced by ZipRecruiter
Industry
Insurance services
Company size
10,000+ Employees
Headquarters location
Minnetonka, MN, US
Year founded
1977