Senior Assistant Vice President - Healthcare Claims AI - Technical Product Leader

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    "Title": "Senior Assistant Vice President - Healthcare Claims AI - Technical Product Leader",
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    "ShortDescriptionStr": "Healthcare Claims AI / Technical Product Leader to own the vision, strategy, and delivery of AI-powered products and solutions across the healthcare claims lifecycle. This role sits at the intersection of product strategy, AI engineering leadership, and healthcare claims domain expertise—spanning claims adjudication, claims adjustment, payment integrity (PI), coordination of benefits (COB), subrogation, provider dispute resolution, and fraud/waste/abuse (FWA) detection. \n\nYou will lead cross-functional teams to architect, build, and operationalize Agentic AI and Generative AI solutions that create measurable value—reducing claims processing costs, accelerating adjudication turnaround, improving payment accuracy, strengthening audit outcomes, and modernizing provider operations workflows. This is a high-visibility leadership role ideal for someone passionate about combining technology, healthcare claims depth, and design thinking to create lasting business impact for national payers. \n\n",
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    "ExternalDescriptionStr": "<p>Healthcare Claims AI / Technical Product Leader to own the vision, strategy, and delivery of AI-powered products and solutions across the healthcare claims lifecycle. This role sits at the intersection of product strategy, AI engineering leadership, and healthcare claims domain expertise—spanning claims adjudication, claims adjustment, payment integrity (PI), coordination of benefits (COB), subrogation, provider dispute resolution, and fraud/waste/abuse (FWA) detection.</p>\n<p>You will lead cross-functional teams to architect, build, and operationalize Agentic AI and Generative AI solutions that create measurable value—reducing claims processing costs, accelerating adjudication turnaround, improving payment accuracy, strengthening audit outcomes, and modernizing provider operations workflows. This is a high-visibility leadership role ideal for someone passionate about combining technology, healthcare claims depth, and design thinking to create lasting business impact for national payers.&nbsp;<br>\n &nbsp;</p>",
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    "CorporateDescriptionStr": "<div>\n EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit&nbsp;<a href=\"http://www.exlservice.com/\" target=\"_blank\" rel=\"nofollow\">www.exlservice.com</a>.\n</div>\n<div>\n <div>\n  <p class=\"MsoNormal\"><br/></p>\n </div><i>EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.</i>\n</div>\n<div>\n</div>",
    "ExternalPostedStartDate": "2026-06-10T22:33:41+00:00",
    "ExternalQualificationsStr": "<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <p><strong>Experience</strong>&nbsp;</p>\n  <ul>\n   <li>15+ years of progressive experience in AI/ML engineering, technical product management, or platform product leadership roles.&nbsp;</li>\n   <li>5+ years of leadership experience in healthcare claims technology, payer claims operations, or health-tech product organizations focused on claims/PI.&nbsp;</li>\n   <li>Proven track record of building and scaling AI solutions for claims processing, payment integrity, or provider operations—from POC to production at an enterprise scale.&nbsp;</li>\n   <li>Experience with large-scale payer claims engagements ($25M+ in managed services or technology contracts) and familiarity with FTE-to-AI transformation models in claims shops.&nbsp;</li>\n   <li>Bachelor's degree in computer science, Engineering, Data Science, or related technical field. Master's degree (M.Tech / MS / MBA) is strongly preferred.&nbsp;</li>\n  </ul>\n  <p><strong>Technical Skills</strong>&nbsp;</p>\n  <ul>\n   <li>Hands-on and architectural expertise in LLMs, embeddings, vector search, prompt engineering, and RAG pipelines.&nbsp;</li>\n   <li>Proficiency with cloud AI platforms: Azure OpenAI, AWS Bedrock (Claude, Sonnet), GCP Vertex AI.&nbsp;</li>\n   <li>Experience with agent orchestration frameworks: LangChain, LangGraph, CrewAI, AutoGen, or equivalent Agentic AI frameworks.&nbsp;</li>\n   <li>Strong understanding of MCP (Model Context Protocol), A2A protocols, and multi-agent system design.&nbsp;</li>\n   <li>Familiarity with browser/desktop automation tools (Playwright, Selenium) as AI agent execution layers for legacy claims system navigation.&nbsp;</li>\n   <li>Familiarity with secure API design, OAuth2/JWT, enterprise integration patterns, and EDI transaction sets (X12 837/835/270/271/276/277).&nbsp;</li>\n  </ul>\n  <p><strong>Domain Skills</strong>&nbsp;</p>\n  <ul>\n   <li>Deep understanding of end-to-end healthcare claims operations: claim submission, edits, adjudication, pricing, payment, adjustment, appeals, grievances, and overpayment recovery.&nbsp;</li>\n   <li>Strong knowledge of pre-pay/post-pay review, DRG validation, CPT/ICD-10/HCPCS code editing, COB, subrogation, and FWA detection methodologies.&nbsp;</li>\n   <li>Experience with claims processing platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC) and provider data management.&nbsp;</li>\n   <li>Understanding of healthcare financial models: PMPM, total cost of care, provider reimbursement methodologies (fee-for-service, value-based, capitation), and gainshare/outcome-based pricing structures.&nbsp;</li>\n   <li>Familiarity with CMS regulations, state DOI requirements, NAIC model acts, and payer audit/compliance frameworks relevant to claims processing.&nbsp;</li>\n  </ul>\n  <p><strong>Leadership &amp; Communication</strong>&nbsp;</p>\n  <ul>\n   <li>Exceptional executive communication skills—ability to present AI strategy and business impact to C-suite audiences (CEO, President, COO) at national payer organizations.&nbsp;</li>\n   <li>Proven ability to influence cross-functional stakeholders across engineering, delivery, sales, and claims operations teams.&nbsp;</li>\n   <li>Experience leading distributed, global teams (US + offshore) in fast-paced, high-growth environments.&nbsp;</li>\n   <li>Strong storytelling ability—translating complex AI capabilities into clear business value, ROI narratives, and claims transformation roadmaps.&nbsp;</li>\n  </ul>\n  <p><strong>Preferred Qualifications&nbsp;</strong></p>\n  <ul>\n   <li>Experience building or leading AI Centers of Excellence or reusable agent frameworks specifically for claims processing or payment integrity.&nbsp;</li>\n   <li>Patent holder, published researcher, or recognized speaker in the AI/healthcare claims innovation space.&nbsp;</li>\n   <li>Experience with document intelligence and IDP platforms for claims-related documents (EOBs, remittance advice, provider contracts, fee schedules).&nbsp;</li>\n   <li>Deep familiarity with healthcare data standards: HL7, FHIR, X12 EDI (837/835/270/271/276/277), NCPDP for pharmacy claims.&nbsp;</li>\n   <li>Experience with Databricks, Snowflake, or similar data platforms in healthcare claims analytics context.&nbsp;</li>\n   <li>Background in consulting or managed services delivery for large payer claims operations.&nbsp;</li>\n   <li>Knowledge of competitive landscape including Optum/Change Healthcare, Cotiviti, Cognizant TriZetto, HealthEdge, Conduent, Gainwell Technologies, and emerging AI-native claims startups.&nbsp;</li>\n   <li>Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AHFI), or similar claims/PI certifications a plus.&nbsp;</li>\n   <li>Experience with claims processing platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC) and provider data management.&nbsp;</li>\n   <li>Understanding of healthcare financial models: PMPM, total cost of care, provider reimbursement methodologies (fee-for-service, value-based, capitation), and gainshare/outcome-based pricing structures.&nbsp;</li>\n   <li>Familiarity with CMS regulations, state DOI requirements, NAIC model acts, and payer audit/compliance frameworks relevant to claims processing.&nbsp;</li>\n  </ul>\n  <p><strong>Leadership &amp; Communication</strong>&nbsp;</p>\n  <ul>\n   <li>Exceptional executive communication skills—ability to present AI strategy and business impact to C-suite audiences (CEO, President, COO) at national payer organizations.&nbsp;</li>\n  </ul>\n </div>\n</div>",
    "InternalQualificationsStr": "<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <p><strong>Experience</strong>&nbsp;</p>\n  <ul>\n   <li>15+ years of progressive experience in AI/ML engineering, technical product management, or platform product leadership roles.&nbsp;</li>\n   <li>5+ years of leadership experience in healthcare claims technology, payer claims operations, or health-tech product organizations focused on claims/PI.&nbsp;</li>\n   <li>Proven track record of building and scaling AI solutions for claims processing, payment integrity, or provider operations—from POC to production at an enterprise scale.&nbsp;</li>\n   <li>Experience with large-scale payer claims engagements ($25M+ in managed services or technology contracts) and familiarity with FTE-to-AI transformation models in claims shops.&nbsp;</li>\n   <li>Bachelor's degree in computer science, Engineering, Data Science, or related technical field. Master's degree (M.Tech / MS / MBA) is strongly preferred.&nbsp;</li>\n  </ul>\n  <p><strong>Technical Skills</strong>&nbsp;</p>\n  <ul>\n   <li>Hands-on and architectural expertise in LLMs, embeddings, vector search, prompt engineering, and RAG pipelines.&nbsp;</li>\n   <li>Proficiency with cloud AI platforms: Azure OpenAI, AWS Bedrock (Claude, Sonnet), GCP Vertex AI.&nbsp;</li>\n   <li>Experience with agent orchestration frameworks: LangChain, LangGraph, CrewAI, AutoGen, or equivalent Agentic AI frameworks.&nbsp;</li>\n   <li>Strong understanding of MCP (Model Context Protocol), A2A protocols, and multi-agent system design.&nbsp;</li>\n   <li>Familiarity with browser/desktop automation tools (Playwright, Selenium) as AI agent execution layers for legacy claims system navigation.&nbsp;</li>\n   <li>Familiarity with secure API design, OAuth2/JWT, enterprise integration patterns, and EDI transaction sets (X12 837/835/270/271/276/277).&nbsp;</li>\n  </ul>\n  <p><strong>Domain Skills</strong>&nbsp;</p>\n  <ul>\n   <li>Deep understanding of end-to-end healthcare claims operations: claim submission, edits, adjudication, pricing, payment, adjustment, appeals, grievances, and overpayment recovery.&nbsp;</li>\n   <li>Strong knowledge of pre-pay/post-pay review, DRG validation, CPT/ICD-10/HCPCS code editing, COB, subrogation, and FWA detection methodologies.&nbsp;</li>\n   <li>Experience with claims processing platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC) and provider data management.&nbsp;</li>\n   <li>Understanding of healthcare financial models: PMPM, total cost of care, provider reimbursement methodologies (fee-for-service, value-based, capitation), and gainshare/outcome-based pricing structures.&nbsp;</li>\n   <li>Familiarity with CMS regulations, state DOI requirements, NAIC model acts, and payer audit/compliance frameworks relevant to claims processing.&nbsp;</li>\n  </ul>\n  <p><strong>Leadership &amp; Communication</strong>&nbsp;</p>\n  <ul>\n   <li>Exceptional executive communication skills—ability to present AI strategy and business impact to C-suite audiences (CEO, President, COO) at national payer organizations.&nbsp;</li>\n   <li>Proven ability to influence cross-functional stakeholders across engineering, delivery, sales, and claims operations teams.&nbsp;</li>\n   <li>Experience leading distributed, global teams (US + offshore) in fast-paced, high-growth environments.&nbsp;</li>\n   <li>Strong storytelling ability—translating complex AI capabilities into clear business value, ROI narratives, and claims transformation roadmaps.&nbsp;</li>\n  </ul>\n  <p><strong>Preferred Qualifications&nbsp;</strong></p>\n  <ul>\n   <li>Experience building or leading AI Centers of Excellence or reusable agent frameworks specifically for claims processing or payment integrity.&nbsp;</li>\n   <li>Patent holder, published researcher, or recognized speaker in the AI/healthcare claims innovation space.&nbsp;</li>\n   <li>Experience with document intelligence and IDP platforms for claims-related documents (EOBs, remittance advice, provider contracts, fee schedules).&nbsp;</li>\n   <li>Deep familiarity with healthcare data standards: HL7, FHIR, X12 EDI (837/835/270/271/276/277), NCPDP for pharmacy claims.&nbsp;</li>\n   <li>Experience with Databricks, Snowflake, or similar data platforms in healthcare claims analytics context.&nbsp;</li>\n   <li>Background in consulting or managed services delivery for large payer claims operations.&nbsp;</li>\n   <li>Knowledge of competitive landscape including Optum/Change Healthcare, Cotiviti, Cognizant TriZetto, HealthEdge, Conduent, Gainwell Technologies, and emerging AI-native claims startups.&nbsp;</li>\n   <li>Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AHFI), or similar claims/PI certifications a plus.&nbsp;</li>\n   <li>Experience with claims processing platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC) and provider data management.&nbsp;</li>\n   <li>Understanding of healthcare financial models: PMPM, total cost of care, provider reimbursement methodologies (fee-for-service, value-based, capitation), and gainshare/outcome-based pricing structures.&nbsp;</li>\n   <li>Familiarity with CMS regulations, state DOI requirements, NAIC model acts, and payer audit/compliance frameworks relevant to claims processing.&nbsp;</li>\n  </ul>\n  <p><strong>Leadership &amp; Communication</strong>&nbsp;</p>\n  <ul>\n   <li>Exceptional executive communication skills—ability to present AI strategy and business impact to C-suite audiences (CEO, President, COO) at national payer organizations.&nbsp;</li>\n  </ul>\n </div>\n</div>",
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    "ExternalResponsibilitiesStr": "<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <p>AI Product Strategy &amp; Roadmap Ownership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Define, own, and evolve the AI product roadmap for healthcare claims solutions—spanning claims adjudication automation, claims adjustment, payment integrity, COB/subrogation, provider issue resolution, and FWA detection.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Translate complex claims operational challenges into AI-first product strategies with clear business cases, ROI frameworks, and measurable KPIs (e.g., auto-adjudication rate, denial accuracy, overpayment recovery yield).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Drive solutions from ideation → POC → MVP → production scale, using agile execution and business-centric prioritization.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Maintain a competitive landscape matrix and continuously benchmark against market players (Optum/Change Healthcare, Cotiviti, Cognizant TriZetto, HealthEdge, Conduent, etc.) to inform differentiation strategy.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Partner with sales, finance, and leadership to determine pricing, packaging, and go-to-market approach (managed services, SaaS, outcome-based/gainshare models).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>2. Technical &amp; AI Engineering Leadership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Drive the transition from traditional rules-engine claims processing to AI-augmented adjudication—automating claim edits, benefit configuration interpretation, provider contract parsing, and payment rule application.&nbsp;</li>\n  </ul>\n </div>\n</div>\n<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Design reusable AI components and platform capabilities (e.g., claims document intelligence, EOB/remittance parsing, provider contract extraction, coding validation engines, browser/desktop automation agents).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Write clear product requirements documents (PRDs), user stories, and technical specifications with well-defined acceptance criteria for engineering teams.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Champion explainability-first AI design, ensuring all models produce audit-ready, evidence-grounded outputs suitable for SIU investigations, CMS audits, and payer compliance reviews.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>3. Healthcare Claims Domain &amp; Operational Transformation&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Apply deep knowledge of end-to-end claims operations—claim intake, edits, adjudication, pricing, payment, adjustment, appeals, grievances, provider disputes, and overpayment recovery—to identify high-impact AI use cases.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Embed AI solutions into core claims platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC, etc.) through platform-agnostic integration and API-first design.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Design AI-driven solutions covering pre-pay and post-pay analytics, DRG validation, code editing (CPT/ICD-10/HCPCS), duplicate claim detection, and provider billing pattern analysis.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build cross-payer intelligence capabilities that leverage anonymized, aggregated claims data to drive payment accuracy benchmarks, denial pattern optimization, and cost-of-care insights.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Support RFP/RFI responses, orals preparation, and executive presentations for national payer pursuits.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Develop AI-powered provider operations solutions—automated provider issue resolution, correspondence generation, contract interpretation, and fee schedule management.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>4. Client Engagement &amp; Thought Leadership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Serve as the product spokesperson and AI SME in client engagements—leading executive presentations, POC demonstrations, workshops, and roadmap discussions with CXO/EVP/VP stakeholders at national payers.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Partner with account management and business development teams to shape differentiated claims AI solutions for complex, enterprise-level healthcare pursuits.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build and deliver compelling thought leadership content—white papers, case studies, conference presentations, and analyst briefings—that position EXL as a leader in claims AI innovation.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Represent EXL at industry conferences (AHIP, HCCA, SIU conferences, RISE, etc.) through presentations, panel discussions, and live product demonstrations.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>5. Team Leadership &amp; Talent Development&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Lead, mentor, and develop a high-performing team of AI engineers, product managers, data scientists, and solution architects focused on claims AI.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Foster a culture of innovation, collaboration, accountability, and continuous learning within the team.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Collaborate with offshore engineering and delivery teams to ensure timely, secure, and scalable implementation.&nbsp;</li>\n  </ul>\n </div>\n</div>\n<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build and scale an AI Center of Excellence for healthcare claims, establishing reusable agent frameworks, governance playbooks, and best practices.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>6. Governance, Compliance &amp; Risk Management&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Champion privacy-first design, data anonymization, and compliance with HIPAA, PHI/PII handling, and payer-specific data governance frameworks.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Ensure all AI solutions meet scalability, security, auditability, and operational excellence requirements for regulated healthcare claims environments.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Establish governance-grade AI controls including model monitoring, bias detection, drift management, and human-in-the-loop override mechanisms for claims decisioning.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Maintain compliance with CMS, state DOI regulations, NAIC guidelines, and payer-specific audit requirements for claims processing and payment integrity.&nbsp;</li>\n  </ul>\n </div>\n</div>",
    "InternalResponsibilitiesStr": "<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <p>AI Product Strategy &amp; Roadmap Ownership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Define, own, and evolve the AI product roadmap for healthcare claims solutions—spanning claims adjudication automation, claims adjustment, payment integrity, COB/subrogation, provider issue resolution, and FWA detection.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Translate complex claims operational challenges into AI-first product strategies with clear business cases, ROI frameworks, and measurable KPIs (e.g., auto-adjudication rate, denial accuracy, overpayment recovery yield).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Drive solutions from ideation → POC → MVP → production scale, using agile execution and business-centric prioritization.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Maintain a competitive landscape matrix and continuously benchmark against market players (Optum/Change Healthcare, Cotiviti, Cognizant TriZetto, HealthEdge, Conduent, etc.) to inform differentiation strategy.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Partner with sales, finance, and leadership to determine pricing, packaging, and go-to-market approach (managed services, SaaS, outcome-based/gainshare models).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>2. Technical &amp; AI Engineering Leadership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Drive the transition from traditional rules-engine claims processing to AI-augmented adjudication—automating claim edits, benefit configuration interpretation, provider contract parsing, and payment rule application.&nbsp;</li>\n  </ul>\n </div>\n</div>\n<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Design reusable AI components and platform capabilities (e.g., claims document intelligence, EOB/remittance parsing, provider contract extraction, coding validation engines, browser/desktop automation agents).&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Write clear product requirements documents (PRDs), user stories, and technical specifications with well-defined acceptance criteria for engineering teams.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Champion explainability-first AI design, ensuring all models produce audit-ready, evidence-grounded outputs suitable for SIU investigations, CMS audits, and payer compliance reviews.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>3. Healthcare Claims Domain &amp; Operational Transformation&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Apply deep knowledge of end-to-end claims operations—claim intake, edits, adjudication, pricing, payment, adjustment, appeals, grievances, provider disputes, and overpayment recovery—to identify high-impact AI use cases.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Embed AI solutions into core claims platforms and systems (QNXT, Facets, Amisys, HealthRules Payer, CSC/DXC, etc.) through platform-agnostic integration and API-first design.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Design AI-driven solutions covering pre-pay and post-pay analytics, DRG validation, code editing (CPT/ICD-10/HCPCS), duplicate claim detection, and provider billing pattern analysis.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build cross-payer intelligence capabilities that leverage anonymized, aggregated claims data to drive payment accuracy benchmarks, denial pattern optimization, and cost-of-care insights.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Support RFP/RFI responses, orals preparation, and executive presentations for national payer pursuits.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Develop AI-powered provider operations solutions—automated provider issue resolution, correspondence generation, contract interpretation, and fee schedule management.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>4. Client Engagement &amp; Thought Leadership&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Serve as the product spokesperson and AI SME in client engagements—leading executive presentations, POC demonstrations, workshops, and roadmap discussions with CXO/EVP/VP stakeholders at national payers.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Partner with account management and business development teams to shape differentiated claims AI solutions for complex, enterprise-level healthcare pursuits.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build and deliver compelling thought leadership content—white papers, case studies, conference presentations, and analyst briefings—that position EXL as a leader in claims AI innovation.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Represent EXL at industry conferences (AHIP, HCCA, SIU conferences, RISE, etc.) through presentations, panel discussions, and live product demonstrations.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>5. Team Leadership &amp; Talent Development&nbsp;</p>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Lead, mentor, and develop a high-performing team of AI engineers, product managers, data scientists, and solution architects focused on claims AI.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Foster a culture of innovation, collaboration, accountability, and continuous learning within the team.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Collaborate with offshore engineering and delivery teams to ensure timely, secure, and scalable implementation.&nbsp;</li>\n  </ul>\n </div>\n</div>\n<div style=\"font-style:normal;font-weight:400;margin:0px;padding:0px\">\n <div style=\"margin:0px;padding:0px\">\n  <ul>\n   <li>Build and scale an AI Center of Excellence for healthcare claims, establishing reusable agent frameworks, governance playbooks, and best practices.&nbsp;</li>\n  </ul>\n </div>\n <div style=\"margin:0px;padding:0px\">\n  <p>6. 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