Remote Medical Claims Processing Jobs in Minnesota

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

As a Senior AI/ML Engineer within the Optum Health & Financial Tech team, you will design, build, and deploy production-grade AI and machine learning solutions that revolutionize healthcare payer and financial operations. You will focus on high-impact areas such as Claims Processing Automation, Eligibility Verification, Prior Authorization, and Payment Integrity. Operating with an innovative mindset, you will leverage advanced technologies-including Natural Language Processing (NLP), Generative AI, and Agentic AI digital workers-to enable touchless processing and drive payment accuracy. Joining a mission-driven team, you will help connect patients, providers, and data, modernizing critical platforms and scaling responsible AI to improve the care and financial experience for millions.

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:

• Design, develop, and deploy production-grade AI-powered solutions and machine learning models to address complex business challenges in claims processing, eligibility, and payment integrity, emphasizing the responsible use of AI
• Use enterprise-approved AI tools to streamline operational workflows, automate repetitive tasks, and drive continuous improvement across payer and financial systems
• Evaluate emerging trends, such as Agentic AI, GenAI, and automation frameworks, to inform solution design and strategic innovation
• Build and optimize scalable data pipelines for real-time and batch processing, integrating AI models with core platforms and systems (e.g., Facets, claims engines)
• Create AI-driven automation solutions to automate repetitive workflows and support touchless claims and eligibility processing
• Partner with cross-functional teams to define scope, success criteria, and delivery milestones, then execute with solid engineering rigor through CI/CD, environment readiness, and quality gates to deliver on schedule without compromising reliability or maintainability
• Monitor, validate, and retrain AI/ML models in production to track accuracy, mitigate drift, and optimize performance metrics (such as cost reduction, cycle time, and quality)
• Ensure HIPAA-compliant design, PHI-safe pipelines, and align all AI solutions with Responsible AI governance and auditability standards
• Partner closely with operations, product, and compliance teams to translate payer business requirements into measurable AI solutions and communicate outcomes

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:

• Bachelor's degree in Computer Science or related field, or 4 years of equivalent experience
• 6 years of experience in software engineering, data engineering, or AI/ML, with a proven track record of deploying production-grade AI/ML solutions
• 3 years of experience working with healthcare data, claims processing, eligibility, and workflows
• 3 years of hands-on experience in modern cloud infrastructure (Azure or Google GCP)
• 3 years of hands-on experience building, training, evaluating, and deploying ML, AI, LLM, or agentic AI solutions in production environments
• 2 years of experience building cloud-based applications, backend services, APIs, or CI/CD pipelines using Azure or GCP
• Experience implementing model monitoring, validation, and performance tracking in a production environment
• Proficiency in Python and experience with distributed data processing frameworks

Preferred Qualifications:

• Master's degree in Computer Science, Engineering, Data Science, or a related field
• Professional certification or training in cloud-based AI platforms (e.g., Azure ML, Databricks)
• Experience in healthcare domain and claims automation
• Experience with Agentic AI implementations in enterprise operations
• Familiarity with Facets or similar healthcare payer platforms
• Proven solid ownership, curiosity, adaptability, and learning agility, with the ability to navigate ambiguity and deliver impactful technical solutions

*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 $120,100 - $214,500 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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