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:
- Convert clinical guidelines into structured decision trees, workflows, and clinical models
- Collaborate with Nurses, Physicians, Medical Directors, and Clinical Informatics teams to clarify clinical requirements
- Participate in clinical discussions and guideline review sessions to ensure accurate interpretation of recommendations
- Validate clinical logic, decision pathways, and workflow designs for accuracy and safety
- Review AI-generated recommendations and user-submitted feedback for clinical appropriateness
- Analyze AI misses, false positives, false negatives, and reasoning gaps
- Provide clinical feedback to AI, product, and engineering teams to improve decision-support systems
- Review and triage clinician-reported issues and feedback
- Ensure clinical content aligns with current guidelines, regulations, and organizational standards
- Update decision trees and clinical models based on guideline changes and new evidence
- Document clinical rationale, assumptions, and modeling decisions
- Support quality assurance, testing, and validation of clinical decision-support tools
- Monitor production issues and identify opportunities for clinical and AI model improvements
- Facilitate knowledge sharing between clinical, product, and engineering teams
- Participate in clinical governance, compliance, and patient safety reviews
- Track and report clinical model performance, feedback trends, and improvement opportunities
- 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 regard 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:
- Quality assurance
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.
Skills Required
- Quality assurance
Optum Compensation & Benefits Highlights
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Leave & Time Off Breadth — PTO accrues each pay period with eight paid U.S. holidays plus a floating holiday, and generous time away is consistently emphasized. This breadth supports planned and unplanned time off beyond standard vacation days.
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Parental & Family Support — Six weeks of paid parental leave, up to two weeks of paid caregiver leave, Bright Horizons back‑up care, and adoption assistance signal strong family-oriented support. EAP access with counseling sessions further extends help to employees and their households.
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Wellbeing & Lifestyle Benefits — Company‑paid short‑ and long‑term disability, Calm app membership, tuition reimbursement, commuter and FSA accounts, and broad employee discounts expand everyday wellbeing resources. Free or low‑cost virtual visits complement these lifestyle supports.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.
