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AI/ML Engineer

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Job Description

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.


Primary Responsibilities:

  • Lead AI/ML solutions to enable touchless claims processing across CMC workflows
  • Analyze complex claim patterns and design intelligent automation to reduce manual effort
  • Build scalable models and rules that improve accuracy, speed, and adjudication quality
  • Partner with SMEs, engineering, and operations to align automation with business goals
  • Monitor model performance, ensure compliance, and provide continuous production support
  • Drive innovation by identifying new automation opportunities that improve efficiency and outcomes

  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

  • Bachelor's degree or equivalent experience
  • Solid experience working on ML frameworks, tensor flow
  • Experience collaborating with SMEs, engineering, and operations to deliver automation
  • Solid expertise in AI/ML engineering, model development, and automation frameworks
  • Deep understanding of claims workflows, data patterns, and healthcare domain logic
  • Hands on skills in Python, ML pipelines, cloud platforms, and scalable solution design
  • Proven ability to analyze complex datasets and build accurate, reliable predictive models
  • Proven solid problem solving, compliance awareness, and ownership of production ready solutions

More Info

About Company

Optum, Inc. is an American pharmacy benefit manager and health care provider. It is a subsidiary of UnitedHealth Group since 2011. UHG formed Optum by merging its existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx.In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits and as of 2019, Optum's revenues have surpassed $100 billion.Also in early 2019, Optum gained significant media attention regarding a trade secrets lawsuit that the company filed against former executive David William Smith, after Smith left Optum to join Haven, the joint healthcare venture of Amazon, JPMorgan Chase, and Berkshire Hathaway.

Job ID: 143418779

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