Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
Come build the AI foundation behind SGS, a modern platform where multi-agent systems can reason, plan, and safely connect to enterprise tools to turn conversations, operational signals, and network patterns into action. In this role, you will own the architecture for the capabilities customers feel every day, including real-time voice translation, voice-based assessments, and call quality audits that help teams respond faster and follow the right procedures. You will also advance our Virtual Investigator to accelerate intake, surface risk early, and turn complex investigative questions into clear, explainable answers.
On the fraud side, you will combine real-time ML, graph analytics, and explainable AI to detect emerging fraud, waste, and abuse across claims, enrollment, provider, and encounter data; uncover collusive networks and billing anomalies; and translate those signals into defensible investigative leads, preventive controls, and KPI visibility leaders can use immediately. You will set the technical direction for orchestration and governance on Azure, raise engineering standards across product lines, and mentor a globally distributed team that ships to production. If you want deep ownership, high-stakes impact, and the chance to define how agentic AI operates at scale in a highly regulated healthcare environment, you will thrive here.
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:
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AI Engineering Projects: Design and implement multi-agent AI systems that use LLMs, memory, and tools to reason, plan, and act autonomously
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Function Calling & Orchestration: Build agent-based solutions that use function calling, dynamic tool integration, and orchestration frameworks such as LangChain, AutoGen, and Semantic Kernel
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Modular Agent Design: Leverage standards such as Model Context Protocol (MCP) to define reusable, secure, and composable tool interfaces
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Voice-Driven Interfaces: Develop voice-first AI agents using ASR technologies such as Whisper and Azure Speech, multi-turn conversation orchestration, and high-quality TTS
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RAG & Memory Pipelines: Design and maintain retrieval and memory pipelines using vector databases and Azure Cognitive Search to ground agents in enterprise knowledge, prior interactions, and operational context
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Fraud, Waste & Abuse Analytics & ML Ops: Design, build, and operationalize supervised and unsupervised models, including classification, clustering, anomaly detection, risk scoring, and graph/network analysis, to detect known and emerging FWA patterns across claims, enrollment, provider, and encounter data. Translate fraud typologies such as upcoding, unbundling, excessive units, duplicate or phantom billing, kickbacks, and encounter discrepancies into scalable model logic, rules, and real-time detection pipelines. Continuously refine detection effectiveness using referral, audit, and recovery outcomes where available
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SQL & Data Engineering for FWA: Develop and optimize complex SQL queries, feature pipelines, and data validation checks for large-scale healthcare analytical workflows, including joins, window functions, aggregations, and performance-aware query design
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Cloud-Native AI Deployment: Build, deploy, and monitor scalable AI services on Azure, including Azure OpenAI, Functions, Service Bus, Cosmos DB, Cognitive Search, and related tools
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Explainability, Investigations & Governance: Produce clear, reproducible model outputs, narratives, visualizations, and KPI reporting that support investigators, clinicians, compliance teams, and business leaders. Contribute to model governance, validation, and documentation practices that ensure transparency, fairness, and regulatory defensibility
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Agentic UX & AI as an Interface: Drive innovation in agentic user experiences, enabling AI to operate external tools and services securely on behalf of users
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Mentorship & Collaboration: Review PRs, mentor junior engineers, and collaborate across India and US time zones in a distributed, agile environment
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:
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Undergraduate degree or equivalent experience
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5+ years of total engineering experience
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5+ years of experience in AI/ML product engineering roles
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5+ years of solid Python development experience; proficiency with ML frameworks such as PyTorch, scikit-learn, and Hugging Face
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5+ years of experience with the Azure AI stack, including Azure OpenAI, Cognitive Services, Functions, Service Bus, and Cognitive Search
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5+ years of experience with fraud detection, anomaly detection, risk scoring, or graph/network analytics pipelines
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3+ years of solid experience with voice systems, including ASR, TTS, and real-time audio or telephony integration
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2+ years of proven experience building and shipping LLM-powered or autonomous agent systems in production
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2+ years of deep experience with LLM integration, tool calling, prompt engineering, and context-aware task execution
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2+ years of hands-on experience with retrieval techniques such as RAG, semantic search, embeddings, and vector databases
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Proven solid SQL development skills, including complex joins, window functions, aggregations, and performance optimization for analytical workloads
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Experience working with healthcare claims, provider, enrollment, encounter, or other highly regulated transactional healthcare datasets
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Demonstrated ability to explain model behavior, risk signals, and analytic findings to nontechnical stakeholders through clear, defensible documentation
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Demonstrated track record of contributing to robust, testable, and scalable engineering systems
Preferred Qualifications:
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Experience building automated evaluation harnesses for LLM and agent workflows, including golden datasets, offline and online testing, and measurable quality metrics such as task success rate, groundedness, or human-review agreement
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Hands-on experience with responsible AI, including prompt injection testing, data exfiltration testing, safety reviews, and guardrails to reduce hallucinations and unsafe outputs in production
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Proven experience implementing end-to-end observability for agentic systems, including distributed tracing, tool-call success rates, latency and error budgets, and token and cost telemetry with actionable alerting
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Proven experience designing secure patterns for tool-enabled agents, including least-privilege access, secrets management, and policy-based controls for tool or API execution such as OAuth scopes, managed identity, and audit logging
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Proven ability to optimize LLM or voice-system performance and cost using techniques such as caching, batching, streaming responses, rate limiting, model routing, and fallback strategies
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Direct experience supporting Medicaid program integrity, healthcare fraud analytics, State Medicaid Agency analytics, or MCO SIU workflows
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Familiarity with Medicaid reimbursement and billing constructs, including ICD-10, CPT/HCPCS, DRGs, revenue codes, NDCs, and encounter data
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Familiarity with MMIS, T-MSIS, PERM, CMS program integrity guidance, or similar state or federal compliance frameworks
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Experience supporting referral, recovery, audit, appeal, or case-prioritization workflows
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Experience developing AI/ML solutions in regulated or government healthcare environments
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 to $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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