Jobs at Optum

Supports healthcare provider network development and contracting operations, including unit-cost budgeting, target setting, financial modeling, contract administration, provider data management, and network initiatives. Analyzes and reports data using Excel and other reporting tools, monitors performance, resolves routine issues, and helps ensure appropriate geographic and specialty distribution across the provider network.

Design, build, train, and deploy AI and machine learning solutions for workforce and HR applications. Develop data pipelines, integrate models into production systems, and apply MLOps practices including automated testing and CI/CD. Evaluate emerging AI technologies, collaborate with engineers, data scientists, and business stakeholders, and uphold responsible AI, data governance, privacy, security, and quality standards.

Own technical delivery for the Curo Medical Management Platform, including architecture, solution design, implementation, release execution, and sprint predictability. Optimize user interfaces, microservices, databases, and infrastructure performance. Develop AI-powered features and integrations, evaluate emerging technologies, support responsible AI adoption, lead technical reviews, and mentor engineering teams.

Design, develop, deploy, and operate production AI/ML systems, including conversational chatbot and virtual assistant platforms. Build and optimize machine learning models, MLOps frameworks, CI/CD pipelines, and containerized deployments. Collaborate with architecture teams, business stakeholders, and technology vendors to create secure, scalable solutions. Maintain architecture diagrams, promote observability and automation, evaluate emerging AI trends, and support model governance, privacy, and ethical AI practices.

Provides 24/7 technical support for internal and external users by troubleshooting hardware, software, network, and application issues. Responsibilities include help desk response, equipment setup and maintenance, desktop software installation and patch evaluation, video conference support, inventory management, incident logging, user education, and escalation of unresolved problems. The role is telecommute-eligible within the U.S. and requires citizenship plus eligibility for a security clearance.

Designs, develops, and maintains scalable Java applications, REST APIs, microservices, database solutions, and SSIS ETL processes. Containerizes applications with Docker and Kubernetes, builds GitHub Actions CI/CD pipelines, monitors production systems using Splunk, and supports code reviews, performance tuning, troubleshooting, and defect resolution. Collaborates in Agile teams and uses generative AI tools to improve development productivity and code quality.

Leads enterprise AI strategy, architecture, and production delivery across generative, agentic, and classical machine learning. Designs LLM, RAG, orchestration, predictive, and advanced analytics solutions for healthcare and pharmacy operations. Establishes MLOps, LLMOps, governance, safety, monitoring, and evaluation frameworks while partnering with executives, product, engineering, and platform teams. Mentors technical practitioners and drives reusable AI standards, services, and accelerators.

Reviews medical records and claims to validate CPT, HCPCS, modifier, and evaluation-and-management coding accuracy. Determines payment recommendations, interprets regulations and reimbursement policies, identifies fraud, waste, abuse, and aberrant billing patterns, and produces detailed case narratives. Manages daily caseloads and productivity standards while meeting compliance deadlines, collaborating with business partners and serving as a coding resource. The role is fully telecommute within the United States.

Provide bilingual English- and Spanish-language telephonic support to patients, customers, and providers. Handle appointment scheduling, insurance verification, patient account creation, demographic updates, electronic health record documentation, and inquiry resolution. Accurately document interactions, protect confidential information under HIPAA, meet quality standards, and escalate complex issues. The role requires a 40-hour schedule in a 24/7 operating environment, including possible weekends, holidays, and overtime.

Supervise and coordinate home health clinical services, direct nursing care, and oversee interdisciplinary staff. Complete OASIS assessments, medication reconciliation, and nursing evaluations; manage referrals, clinician assignments, start-of-care scheduling, insurance approvals, and individualized plans of care. Ensure services comply with physician orders, home health eligibility requirements, and applicable regulations while reviewing care plans and supporting clinicians.

Creates high-priority sales and growth enablement materials for pharmacy businesses, including presentations, collateral, training content, campaign support, and client-facing assets. Translates complex clinical, product, operational, regulatory, and value-based information into clear, compliant sales narratives. Manages a high-volume deliverables queue, maintains content accuracy and version control, supports launches and field readiness, and collaborates with marketing, sales, product, clinical, legal, and business stakeholders.

Provides primary care to primarily Medicare-aged patients in a Harlingen clinic. Manages patient care, collaborates with physicians and specialists, supports preventative health initiatives, and practices within a multidisciplinary clinical team. The role emphasizes quality over volume, care coordination, and improving outcomes for older adults.

Provides comprehensive hospice nursing case management, including initial and ongoing patient assessments, eligibility evaluation, individualized plan-of-care development, treatment implementation, clinical documentation, patient and family education, and coordination with physicians and interdisciplinary team members. The role delivers care in patients’ homes and supports physical, psychosocial, emotional, and spiritual needs of patients and families facing end-of-life care.

Design, develop, test, deploy, and maintain Java-based microservices and distributed applications. Build cloud-native containerized systems using Kubernetes and Azure, AWS, or GCP; develop SQL queries and stored procedures; support Kafka event-driven architectures; maintain CI/CD pipelines and monitoring; and contribute throughout the SDLC. The role supports mission-critical 24/7 systems, collaborates with cross-functional Agile teams, and uses AI Copilot tools for development productivity.

Coordinates care for high-risk members by developing individualized care plans, supporting referrals, educating members and providers, and monitoring care across the healthcare continuum. Acts as a liaison among members, physicians, multidisciplinary teams, and health plans while supporting quality improvement, clinical operations, grievance documentation, and treatment decision support. The role requires an unrestricted New York RN license, clinical and health plan case management experience, and proficiency in remote telephonic care coordination.

Provides overnight and weekend hospice nursing care, including phone triage, crisis response, admissions, evaluations, routine and end-of-life visits, recertifications, reassessments, documentation, and patient-family support across multiple Virginia counties.

Develop and maintain full-stack applications on an Agile Scrum team using .NET, C#, microservices, React, Angular, Azure, databases, and AI technologies. Design user interfaces, web services, database schemas, and well-documented code; support cloud applications and data migration. Perform testing, solve complex technical issues, collaborate with stakeholders, and mentor junior and mid-level engineers.

Provides patient access and central registration services in a clinical setting. Responsibilities include greeting and registering patients, verifying demographics and insurance benefits, processing referrals and authorizations, collecting payments, discussing financial obligations, scheduling services, responding to inquiries, and reviewing patient data reports for accuracy.

Designs, administers, and optimizes enterprise backup, recovery, and cyber resilience solutions across on-premises, hybrid-cloud, and public-cloud environments. Leads backup and disaster recovery initiatives, ensures RPO/RTO compliance, develops Terraform-based infrastructure automation, and scripts operational processes using Python, PowerShell, and Bash. Implements monitoring, observability, immutable backups, cyber vaults, isolated recovery environments, and air-gapped recovery capabilities. Troubleshoots complex infrastructure issues, supports audits and compliance, and drives technical roadmaps and operational excellence.

Provides diabetes self-management education, nutritional assessment, and counseling to patients and families. Develops and maintains diabetes education programs, evaluates patient needs, supports high-risk diabetes management, educates staff, creates patient resources, and ensures compliance with clinical and regulatory standards. Collaborates with physicians, nursing, health coordinators, marketing, and ancillary services to promote safe, effective, coordinated care.