Tata Consultancy Services

US Healthcare Payor Transformation Lead

Tata Consultancy Services • $187K — $253K *
Chicago, IL 60629In-Person
Healthcare
Less than 5 years of experience
1 week ago
Job Overview by Ladders

Qualifications

  • Strong expertise and leadership background in US Healthcare Payer
  • Techno-functional knowledge of Medicare, Medicaid, and Commercial lines of business
  • In-depth understanding of AI transformation opportunities for Payers
  • Proven experience in leading comprehensive payer transformation initiatives
  • Experience in AI-driven transformations across claims, prior authorization, and clinical areas
  • Deep insight into payer operational models and data management
  • Strong stakeholder engagement experience at the CXO level

Responsibilities

  • Define and lead the AI-driven transformation vision for healthcare payers
  • Engage with senior executives to shape strategic transformation roadmaps
  • Identify and drive impactful AI use cases for payer operations
  • Partner with engineering teams to modernize payer platforms
  • Develop business-aligned solution architectures for transformation
  • Lead strategic business development initiatives by proposing innovative solutions
  • Conduct AI transformation workshops for client education and engagement

Benefits

  • Opportunities for innovation and thought leadership through published whitepapers
  • Access to reusable frameworks and solution accelerators
  • Collaboration with cutting-edge engineering teams to design advanced systems
  • Engagement in high-level strategic discussions with industry leaders
  • Involvement in shaping the future of healthcare transformation initiatives
Full Job Description
  • Strong domain expertise and leadership experience in US Healthcare Payer
  • Techno-functional understanding of Payer lines of business including Medicare, Medicaid, and Commercial
  • Deep understanding of AI led transformation possibilities for the Payers
  • Proven track record of leading end-to-end payer transformation programs
  • Demonstrated experience in AI-led reimagination of payer business (e.g., claims modernization, prior authorization transformation, contact center transformation, Clinical transformation, Value based care)
  • Deep understanding of payer operating model + data flows across claims, provider, membership, and care management
  • Ability to shape transformation vision, define value articulation, and drive execution at scale
  • Strong CXO-level stakeholder management and advisory experience with US payer clients
  • Knowledge of regulatory mandates and interoperability requirements


ROLES & RESPONSIBILITIES

  • Define and lead AI-led payer transformation vision Establish forward-looking transformation strategies for US healthcare payer organizations by reimagining core business processes (claims, prior authorization, provider, member engagement, digital and data) using AI, GenAI, and advanced analytics
  • Act as a CXO-level strategic advisor Engage with senior client stakeholders (COO, CIO, CDO) to shape transformation roadmaps, define value cases, and influence business and technology decisions
  • Reimagine payer business processes with AI Identify high-impact AI/GenAI use cases (e.g., autonomous claims adjudication, intelligent prior authorization, payment integrity, conversational AI for member/provider interactions) and drive their incubation, scaling, and industrialization
AI led Transformation Enablement
  • Partner with delivery and engineering teams to Design payer platforms modernization strategies (Core Admin Systems, Digital Front Door)
  • Define business-aligned solution architectures for payer transformation


Business Development

  • Lead large deal pursuits by providing transformative domain-led solutioning and proposal inputs,
  • Conduct AI led transformation workshops for customers as an industry authority


Innovation & Thought Leadership

  • Develop reusable assets: Payer domain frameworks, Solution accelerators and reference architecture
  • Publish whitepapers, POVs, and internal knowledge artifacts


Salary Range: 187200-253300 a year

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About Tata Consultancy Services

Tata Consultancy Services (TCS) is an Indian multinational information technology (IT) services and consulting company, headquartered in Mumbai, Maharashtra, India. It is a subsidiary of Tata Group and operates in 149 locations across 46 countries. TCS is the largest Indian company by market capitalization and is ranked 11th on the Forbes Global 2000 list of the world's biggest public companies. TCS is also the second-largest IT services company in the world by revenue and the largest employer of women in India. The company provides services in areas including IT, consulting, and business solutions.
Learn more about Tata Consultancy Services
Size
469,261 employees
Industry
Information Technology
* Ladders Estimates

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