OneMain Financial Jobs

Requisition number: 2344625

Job category: Technology

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:

• Product Strategy & Vision (Back Office RCM)

• Define the enterprise vision and multi-year product strategy for AI-enabled automation across claims follow-up, denial prevention, denial management, and appeals workflows

• Identify high-friction, labor-intensive back-office RCM processes and translate them into clear automation opportunities with measurable operational and financial impact

• Develop compelling business cases tied to cost avoidance, productivity lift, cash acceleration, and denial risk reduction

• Ensure product strategy aligns with payer policies, contract terms, regulatory requirements, and industry best practices for appeals and post-bill workflows

• Roadmap Leadership

• Own and prioritize the product roadmap for claims status automation, denial management, appeal generation, and payer follow-up

• Balance short-term operational lift with longer-term platform and intelligence investments

• Establish and track OKRs across automation rate, touchless resolution, turnaround time, overturn rate, and net revenue recovery

• Drive iterative delivery cycles that rapidly validate value in live back-office RCM environments

• Technical Product Ownership

• Lead product design for AI/ML-driven back-office RCM workflows, including:

• Denial intelligence and root cause classification

• Automated claim status monitoring and follow-up

• Appeal letter generation and clinical/technical evidence assembly

• Partner with data science teams on model objectives, training datasets (payer responses, EOBs, remits, appeal outcomes), feature engineering, and model evaluation

• Drive technical alignment across RCM platforms, clearinghouses, payer portals, Voice AI, EHRs, document management systems, and workflow tools

• Ensure explainability, auditability, and defensibility of AI-driven decisions in payer-facing workflows

• Execution & Delivery Excellence

• Drive agile execution across engineering, data science, and RCM operations teams to ensure predictable, high-quality delivery

• Maintain a rigorous Definition of Done that includes:

• Accuracy thresholds and confidence scoring

• Validation against real-world payer outcomes

• Clear handoff logic between automation and human work queues

• Proactively identify and mitigate risks related to:

• Model drift and payer behavior changes

• Data quality and document variability

• Operational adoption and trust in automation

• Regulatory or compliance exposure

• Customer Impact & Performance

• Own end-to-end outcomes for back-office automation, including:

• Productivity improvement and FTE capacity release

• Reduction in manual follow-up and rework

• Improved appeal success rates and faster resolution times

• Measurable financial uplift and cash flow acceleration

• Lead discovery, workflow validation, and pilot efforts with operations leaders and end users to ensure automation fits real-world denial and follow-up workflows

• Translate performance insights into roadmap decisions, operational dashboards, and executive-ready customer reporting

• Compliance & Employment Obligations

• Comply with the terms and conditions of the employment contract, company policies and procedures, and all applicable directives related to work location, team assignments, work schedules, flexibility policies, and alternative work arrangements

• The Company may adopt, vary, or rescind these policies and directives at its discretion in response to evolving business needs

• 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 or Master's degree in IT, Computer Science, Health Information Management (HIM), Health Sciences, Product Management, Analytics, or a related field

• 13+ years in healthcare services, healthcare technology, or software development

• 7+ years of experience in healthcare services, healthcare technology, or enterprise software development

• 3+ years in product management or technical product roles focused on AI/ML, workflow automation, or intelligent platforms

• 3+ years of direct experience in back-office RCM operations

• 3+ years leading large, matrixed initiatives across engineering, data science, RCM operations, and clinical or payer-facing teams

• #exectech

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.