- Deep expertise in Healthcare Payer operations, including areas such as:
- Claims management
- Prior authorization
- Utilization management
- Care management
- Provider data management
- Enrollment and eligibility
- Risk adjustment
- Revenue integrity
- Appeals and grievances
- Customer/member service operations
- Experience helping healthcare organizations improve operational performance through technology-driven transformation initiatives.
- Ability to connect business challenges with technical solutions and articulate measurable business value.
- Strong understanding of AI, automation, enterprise applications, and modern technology architectures.
- Experience leading consultative discovery conversations with executive, business, and technical stakeholders.
- Demonstrated ability to simplify and communicate complex technical concepts to both technical and non-technical audiences.
- Knowledge of continuous improvement methodologies, operational excellence frameworks, and process transformation practices.
- Experience working with large enterprise organizations in complex, highly regulated environments.
- Background in sales engineering, consulting, solution architecture, digital transformation, intelligent automation, or related fields.
- Intellectual curiosity, adaptability, and a passion for continuous learning.
- Strong collaboration and relationship-building skills.
- Requires up to 25% travel
- Candidates must be authorized to work in the United States for this role