Strong domain expertise and leadership experience in US Healthcare Payer Techno-functional understanding of Payer lines of business including Medicare, Medicaid, and Commercial Deep understanding of AI led transformation possibilities for the Payers Proven track record of leading end-to-end payer transformation programs Demonstrated experience in AI-led reimagination of payer business (e.g., claims modernization, prior authorization transformation, contact center transformation, Clinical transformation, Value based care) Deep understanding of payer operating model + data flows across claims, provider, membership, and care management Ability to shape transformation vision, define value articulation, and drive execution at scale Strong CXO-level stakeholder management and advisory experience with US payer clients Knowledge of regulatory mandates and interoperability requirements
ROLES & RESPONSIBILITIES
Define and lead AI-led payer transformation vision - Establish forward-looking transformation strategies for US healthcare payer organizations by reimagining core business processes (claims, prior authorization, provider, member engagement, digital and data) using AI, GenAI, and advanced analytics Act as a CXO-level strategic advisor - Engage with senior client stakeholders (COO, CIO, CDO) to shape transformation roadmaps, define value cases, and influence business and technology decisions Reimagine payer business processes with AI - Identify high-impact AI/GenAI use cases (e.g., autonomous claims adjudication, intelligent prior authorization, payment integrity, conversational AI for member/provider interactions) and drive their incubation, scaling, and industrialization AI led Transformation Enablement
Partner with delivery and engineering teams to Design payer platforms modernization strategies (Core Admin Systems, Digital Front Door) Define business-aligned solution architectures for payer transformation
Business Development
Lead large deal pursuits by providing transformative domain-led solutioning and proposal inputs, Conduct AI led transformation workshops for customers as an industry authority
Innovation & Thought Leadership
Develop reusable assets: Payer domain frameworks, Solution accelerators and reference architecture Publish whitepapers, POVs, and internal knowledge artifacts
Salary Range: 187200-253300 a year
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