AI Transformation & Operations Lead

Devoted Health • Waltham, MA

12d

About The Position

A bit about this role: The Claims AI Operations Lead will lead the transformation of our Claims operational model into an AI-native ecosystem. Reporting to the VP of Claims, you will design, implement, and continuously optimize a hybrid operating model that blends AI agents and human operators to drive efficiency, quality, and innovation across day-to-day claims operations. Embedded directly within the Claims organization, you will serve as the bridge between operational reality and technological capability. You will work in close partnership with Technology teams to extend the impact of existing tools and identify new opportunities that require technical development or integration. You will ensure that AI systems and our claims talent work seamlessly together—delivering measurable outcomes and building a more adaptive, data-driven operating model.

Requirements

• AI & Technical Fluency: Deep understanding of AI systems, automation platforms, and LLM-based agent orchestration frameworks with 1+ years of hands-on experience applying generative AI in real-world workflows, products, or operational use cases.
• Data & Operational Insights: Proficiency with data, analytics, and business intelligence platforms (e.g.,Snowflake or Looker) to drive AI-driven decision-making and bridge the gap between business challenges and technical opportunities.
• Operational Excellence: Background in technology, operations, or process re-engineering, ideally within a scaled service or technical environment. You are a strong systems thinker who can visualize the end-to-end claims lifecycle.
• Change Management: Excellent communication skills with the ability to influence across disciplines. You can champion a culture of confident and ethical AI adoption, helping frontline teams pivot to new ways of working.
• Relationship Builder: Proven ability to build strong cross-functional relationships, prioritizing collaborative and empathetic communication with Product, Engineering, and Data teams.
• Strategic Analytical Horsepower: Proven ability to leverage complex data sets to inform strategic initiatives, while articulating compelling, data-driven narratives that drive organizational vision.
• Bachelor’s degree required, or equivalent work experience.

Nice To Haves

• Experience in healthcare technology, insurance claims, or tech operations is strongly preferred.
• Proven ability to thrive in a fast-paced startup environment.
• Passion for experimentation, continuous learning, and building the next generation of AI-augmented operations.

Responsibilities

• Operational Transformation: Redefine claims workflows to leverage AI agents and automation, ensuring end-to-end processes are optimized for speed, accuracy, explainability, and scalability. You will partner with operational leaders to reimagine service delivery through AI-native design principles.
• AI Agent Orchestration: Design, build, and oversee AI agents (task-specific and multi-agent systems), integrating them seamlessly into existing claims workflows.
• Human–AI Collaboration: Define orchestration models and accountability frameworks for hybrid human–AI work. You will establish clear protocols for how AI systems and claims operators interact—including task assignment, escalation paths, and oversight protocols.
• Monitoring & Governance: Implement monitoring frameworks to track AI agent performance, data quality, cost, and drift. You will collaborate with compliance and risk partners to ensure safe and responsible AI use within the highly regulated insurance environment.
• Cross-Functional Collaboration: Partner closely with Product, Engineering, and Data teams to ensure operational needs inform technology priorities. You will translate operational insights into actionable feedback for technology teams to extend and refine existing tools.
• Training & Enablement: Build programs that elevate AI fluency across the Claims organization. You will equip frontline operators and managers with the skills and confidence to supervise and collaborate effectively with AI systems.
• Innovation & Experimentation: Lead pilots and structured experiments to test new agentic patterns, workflows, or orchestration strategies.
• Metrics & Outcomes: Define and track KPIs for human–AI collaboration, such as throughput, decision accuracy, automation coverage, and cost-to-serve.

Benefits

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level