About The Position
This role is for a Healthcare Claims AI / Technical Product Leader responsible for the vision, strategy, and delivery of AI-powered products and solutions throughout the healthcare claims lifecycle. The position requires a blend of product strategy, AI engineering leadership, and expertise in healthcare claims, including adjudication, adjustment, payment integrity (PI), coordination of benefits (COB), subrogation, provider dispute resolution, and fraud, waste, and abuse (FWA) detection. The individual will lead cross-functional teams to design, develop, and implement Agentic AI and Generative AI solutions aimed at reducing claims processing costs, speeding up adjudication, enhancing payment accuracy, improving audit results, and modernizing provider operations. This is a high-visibility leadership position for individuals passionate about leveraging technology, healthcare claims knowledge, and design thinking to drive significant business impact for national payers.
Requirements
- Expertise in healthcare claims domain, spanning claims adjudication, claims adjustment, payment integrity (PI), coordination of benefits (COB), subrogation, provider dispute resolution, and fraud/waste/abuse (FWA) detection.
- Experience in product strategy.
- Experience in AI engineering leadership.
- Experience with Agentic AI and Generative AI solutions.
- Ability to lead cross-functional teams.
- Passion for combining technology, healthcare claims depth, and design thinking.
Responsibilities
- Own the vision, strategy, and delivery of AI-powered products and solutions across the healthcare claims lifecycle.
- Lead cross-functional teams to architect, build, and operationalize Agentic AI and Generative AI solutions.
- Create measurable value by reducing claims processing costs, accelerating adjudication turnaround, improving payment accuracy, strengthening audit outcomes, and modernizing provider operations workflows.
- Combine technology, healthcare claims depth, and design thinking to create lasting business impact for national payers.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
