Join Optum, a global leader in healthcare solutions, and drive innovation in health optimization. We leverage technology to empower millions toward healthier lives by connecting them with essential care, pharmacy benefits, data, and resources. Our inclusive culture fosters collaboration with talented peers, offering comprehensive benefits and ample career development opportunities. Contribute to advancing global health outcomes while experiencing a culture of Caring, Connecting, and Growing together.

This role is central to developing cutting-edge AI/ML and Generative AI solutions, particularly for Core Claims initiatives such as Duplicate Overpayments, Fraud, Waste & Abuse (FWA) Disputes, and First Pass Claims. You will be instrumental in building and deploying advanced applications using Large Language Models (LLMs), prompt engineering, and Retrieval-Augmented Generation (RAG) frameworks.

Design, develop, and implement AI/ML and Generative AI solutions for Core Claims initiatives. Develop and deploy LLM-powered applications, prompt engineering solutions, and RAG frameworks. Automate claims workflows using AI techniques, including classification, routing, document understanding, and decision support. Collaborate with cross-functional teams to build scalable AI solutions addressing complex business challenges. Develop frameworks for model evaluation, performance testing, validation, and continuous improvement. Partner with data science and engineering on feature engineering, deployment, and production support. Ensure adherence to Responsible AI practices like explainability, governance, fairness, and validation. Identify opportunities for operational efficiency through AI-driven automation. Stay updated on the latest advancements in AI, Generative AI, and LLMs.

A Bachelor's or Master's degree in Computer Science, AI, Machine Learning, Data Science, or a related field is required. Possess 7+ years of experience in AI/ML solution development, with specific expertise in Generative AI and LLMs. Demonstrated experience building and deploying LLM applications, RAG architectures, prompt engineering, and intelligent automation. Proficiency with model evaluation frameworks, performance optimization, and AI solution validation. Experience collaborating effectively with engineering, analytics, product, and business teams. Solid understanding of Responsible AI principles, model explainability, governance, and ethical AI. Strong command of Python and modern AI/ML frameworks and toolchains. Excellent problem-solving, communication, stakeholder management, and presentation skills.