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Position Details: US Healthcare Payor Transformation Lead-Innovation and Transform
| Location: | Chicago, IL |
| Openings: | 1 |
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
- 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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