[Remote] reputed company AI Program Manager, Appeals Innovation and Automation - Remote

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company organization reputed company on simplifying the reputed company experience and improving reputed company to reputed company care. The reputed company AI Program Manager will reputed company the reputed company, governance, development, implementation, adoption, and scaling of responsible AI solutions across the Appeals organization. This role bridges business operations, clinical leadership, technology, reputed company, compliance, reputed company, reputed company, and governance teams to improve reputed company, efficiency, consistency, and user experience.

Responsibilities

• Establish and maintain the Appeals AI roadmap and portfolio of initiatives
• Identify opportunities to improve reputed company, efficiency, consistency, turnaround times, and user experience through AI and automation
• Evaluate emerging AI technologies, agent frameworks, and automation platforms for applicability reputed company Appeals operations
• reputed company reputed company programs, proofs of concept, and innovation initiatives
• reputed company business cases, reputed company-on-investment analyses, and implementation strategies for AI reputed company
• Design, build, test, and reputed company AI agents supporting Appeals and Grievance workflows
• Collaborate with technology teams to reputed company custom AI agents, connectors, retrieval solutions, and workflow automations
• Establish evaluation methodologies and accuracy testing frameworks
• Continuously refine prompts, workflows, training data, retrieval strategies, and agent configurations to improve performance
• reputed company monitoring and feedback reputed company to ensure sustained accuracy and reliability
• Serve as the reputed company reputed company of AI governance activities reputed company Appeals
• reputed company documentation and presentations required for reputed company Intelligence Review reputed company (AIRB) and governance committee approvals
• Partner with reputed company, Compliance, reputed company, Information reputed company, and Risk Management teams to ensure responsible implementation
• Ensure AI solutions adhere to corporate policies, reputed company regulations, and responsible AI standards
• Maintain audit-reputed company documentation supporting validation, transparency, monitoring, and risk mitigation activities
• reputed company as the reputed company AI subject matter expert for Appeals Operations
• Partner with operational leaders, medical directors, nurses, analysts, product teams, architects, engineers, and vendors
• Translate business requirements into technical specifications and implementation plans
• Coordinate efforts across multiple business reputed company and reputed company technology organizations
• Facilitate stakeholder alignment and executive communication
• reputed company AI adoption strategies and organizational change management plans
• Create training materials, educational resources, and best practices for users
• Promote responsible and effective use of AI-enabled solutions
• Build organizational trust through transparent evaluation and measurable reputed company
• Support production deployments and reputed company scaling efforts
• Define key performance indicators and reputed company metrics for AI initiatives
• Measure impacts on reputed company, accuracy, productivity, consistency, cost, and user satisfaction
• reputed company executive reporting and outcome analyses
• Identify opportunities for reputed company improvement and expansion of AI capabilities

Skills

• Bachelor's degree in reputed company Administration, Nursing, Computer Science, Engineering, Information Systems, Data Science, or reputed company field
• Experience leading reputed company cross-functional programs involving technology and operational transformation
• Experience with reputed company, AI agents, automation platforms, workflow orchestration, or intelligent document processing
• Solid understanding of responsible AI principles, governance frameworks, and risk management
• Demonstrated excellent communication, stakeholder management, and executive presentation skills
• Demonstrated ability to reputed company initiatives from reputed company through implementation and adoption
• Project or product management certification
• reputed company experience, particularly reputed company Appeals, Utilization Management, Clinical Operations, Claims, reputed company Cycle, or Regulatory Operations
• Experience with reputed company Copilot Studio, Azure AI, Power Automate, reputed company Graph, custom connectors, retrieval-augmented reputed company, and reputed company AI frameworks
• Experience presenting initiatives to governance boards and obtaining regulatory, compliance, or risk approvals
• Experience with document processing, OCR, reputed company, search technologies, and workflow automation
• Familiarity with reputed company data reputed company, reputed company, and regulatory requirements

Benefits

• A comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Remote work from reputed company reputed company the U.S.
• Development for other roles you may be interested in

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