Empowered to lead this work across clinical operations, you’ll report directly to our SVP & Chief Medical Officer and partner closely with care management, pharmacy and utilization management teams, as well as accreditation and medical policy teams to influence automation strategy, elevate operational efficiency, improve member clinical support, and imagine what’s possible beyond today’s tooling. You won’t just be designing AI pipelines—you’ll shape how AI comes to life across the organization.

To do that, you’ll need:

• Experience with Generative AI, LLM integration, or agent frameworks

• Understanding of APIs, orchestration, and integration patterns

• Proficiency in Python and associated AI / ML libraries and frameworks

• Willingness to understand care management and utilization management platforms and supports

• To abide by HIPAA guidelines

Our ideal candidates will also bring experience in healthcare (other payers, hospital systems, health tech companies) and/or supporting clinical teams.

If you’re inspired by our  – peace of mind through better health – and ready for a role where your technical leadership directly influences AI strategy and innovation, we’d love to hear from you.

Job Responsibilities

Enterprise Process Discovery & Opportunity Assessment 

• Lead discovery sessions with business leaders and SMEs to map current processes, uncover inefficiencies, and identify high impact automation opportunities. 

• Use structured interviews, system data, and workflow analysis to size opportunities and align on measurable outcomes. 

• Translate business needs into clear, actionable automation requirements.

Automation Workflow Design & Enablement

• Architect and develop end to end automated workflows that streamline operations across multiple business domains. 

• Integrate with internal systems and external platforms while following governance, privacy protections, and healthcare compliance requirements. 

• Build solutions that balance reliability, scalability, and usability—favoring practical automation patterns over highly complex AI architectures. 

• Maintain documentation, operational guidance, and change control processes for all deployed workflows.

Business Partnership, Communication & Stakeholder Education

• Serve as a trusted advisor to functional and executive or division leaders, guiding them through automation strategy, prioritization, and value definition. 

• Communicate solutions in accessible language that supports informed decision making across technical and nontechnical audiences. 

• Lead training, demos, and hands on sessions to enable adoption, build confidence, and ensure long term ownership by business teams.

Change Leadership & Adoption Management

• Champion a culture of responsible automation by addressing concerns, building trust, and shaping readiness across teams. 

• Create and promote internal playbooks, best practices, and frameworks that support consistent automation development across the enterprise. 

• Partner with operational, compliance, and security teams to ensure solutions meet payer industry requirements and align to enterprise guardrails.

Governance, Standards & Influence

• Establish enterprise automation standards, design patterns, and guidance to ensure consistent quality and responsible use. 

• Influence enterprise strategy by evaluating tools, platforms, and capabilities needed to sustain long term automation growth. 

• Provide strategic insight to leadership based on cross functional trends, recurring challenges, and emerging opportunities. 

Job Qualifications

Education

• Bachelor’s degree in Computer Science, Engineering, Information Systems, or a related field; Master’s preferred. 

Experience

• 5+ years of experience in workflow automation, process redesign, business systems integration, software engineering, or equivalent skills and experience. 

• 4+ years hands-on experience with AI, LLM-based agents, workflow orchestration, or intelligent automation. Experience with healthcare payers is a plus. 

• Demonstrated ability to lead automation or digital transformation initiatives in a complex or regulated environment. 

• Proven track record partnering with business executives and driving enterprise level change.
• Understanding of APIs, orchestration, and integration patterns. 
• Experience with Generative AI, LLM integration, or agent frameworks 

Skills/Certifications

• Broad automation and workflow engineering experience (e.g., APIs, lowcode tools, orchestration, integration patterns). 
• Strong process thinking mindset with the ability to redesign workflows end-to-end. 
• Exceptional communication, facilitation, and storytelling skills — able to bridge business and technical perspectives. 
• Strength in stakeholder management, negotiation, and driving alignment across teams. 
• Comfort with AI enabled tools and LLM powered assistants. 
• Experience crafting training, enablement, and operational readiness programs for large, distributed user bases.
• Strong to advanced proficiency in Python and associated AI / ML libraries and frameworks. 

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