Director, AI and Automation

Capital Blue Cross•Harrisburg, PA

About The Position

This role leads the organization's strategy and implementation of AI and automation technologies to drive business transformation, operational efficiency, and competitive advantage. This leadership role bridges technical expertise with business acumen to deliver measurable impact across the enterprise. This role is accountable for identifying, prioritizing, and delivering high value use cases that enhance operational efficiency, member and provider experience, compliance, and business transformation.-The ideal candidate has deep expertise in Robotic Process Automation (RPA), major AI/ML platforms, large-language-model (LLM)-based automation, and understands the integration points across core payer systems such as Facets, TruCare. This leader possesses exceptional communication skills to influence at all levels - translating complex AI concepts into business-friendly language and helping stakeholders understand ROI, risks, and value generation.

Requirements

Minimum 7 years of experience in IT with at least 3 years leading automation or AI initiatives.
Deep knowledge of: Automation technologies (RPA, workflow automation, intelligent document processing) AI/ML solutions (machine learning, NLP, LLMs, predictive analytics) API integration and modern cloud services (Azure highly preferred) Core payer systems and processes (Facets, claims, enrollment, provider data, care management)
Proven track record of delivering high-impact automation programs and measurable ROI.
Strong understanding of healthcare payer regulatory environment (HIPAA, CMS).
Exceptional communication and storytelling abilities to translate technical concepts to senior leadership, operations teams, and non-technical stakeholders.
Experience managing cross-functional teams and collaborating with executive stakeholders
Excellent communication skills with ability to translate technical concepts for non-technical audiences
Bachelor's degree in Computer Science, Information Systems, Engineering, Data Science, or related field; advanced degree preferred

Responsibilities

Develop and execute AI and automation roadmaps aligned with business objectives and digital transformation initiatives
Establish a clear roadmap for automation capabilities including RPA, intelligent document processing, machine learning, generative AI, and workflow automation.
Partner with senior executives to evangelize AI capabilities, guide investment decisions, and promote responsible AI adoption.
Collaborate with business leaders to identify opportunities where automation and AI can improve efficiency, reduce manual effort, improve accuracy, and enhance customer experience.
Identify and prioritize high-value use cases for AI implementation and process automation across departments
Conduct ROI assessments, business case development, value tracking, and continuous improvement evaluations.
Maintain a portfolio of AI/automation initiatives, ensuring transparency on benefits, risks, and delivery progress.
Help with evaluation, selection, and integration of AI platforms, tools, and technologies
Oversee the end-to-end design, development, testing, and deployment of automation solutions leveraging: RPA tools (e.g., UiPath, Automation Anywhere, Blue Prism, Salesforce) AI/ML platforms and cloud-based AI services (Azure, AWS, Google, etc.) LLM-based automation and generative AI capabilities Integration with core payer platforms (e.g., Facets, TruCare)
Drive a culture of innovation, continuous improvement, and AI literacy throughout the organization
Ensure solutions meet enterprise architecture, data governance, and security standards.
Establish best practices, reusable patterns, and delivery frameworks for automation and AI.
Build and lead a high-performing team of automation engineers, AI specialists, data scientists, and business analysts.
Foster a culture of innovation, experimentation, and continuous learning.
Partner closely with Enterprise Architecture, Data & Analytics, Cybersecurity, and Agile product teams to ensure cohesive delivery.
Drive a culture of innovation, continuous improvement, and AI literacy throughout the organization
Partner with AI Governance council to establish and maintain governance frameworks, best practices, and ethical guidelines for responsible AI development and deployment, ensuring transparency, fairness, and regulatory alignment.
Ensure adherence to HIPAA, CMS regulations, and payer-specific compliance requirements.
Work with risk, legal, compliance, AI Governance Council teams to assess AI impacts and establish mitigation measures.