US Healthcare Payor Transformation Lead

Job description

• 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 #LI-MM6