Payer Domain Transformation Lead

3 days ago

Chennai, Tamil Nadu, India beBeeExecutive Full time ₹ 12,00,000 - ₹ 15,20,000

Executive Leadership Opportunity

 

Job Overview:

A highly sought-after Executive Leader is needed to spearhead the payer domain, driving strategic growth through innovation and collaboration.

 

Key Responsibilities:

  • Pioneer transformative initiatives leveraging data analytics, AI, automation, and predictive modeling to enhance payer services.
  • Partner with product and engineering teams to design and deploy cutting-edge claims adjudication systems, payment integrity platforms, and member/provider CRM portals.
  • Oversee end-to-end payer technology delivery, encompassing claims adjudication workflows, payment post-processing, provider reimbursement models, and customer-facing systems.
  • Foster high-performing teams of product, engineering, and project management professionals.
  • Nurture key external relationships with payers, providers, brokers, employers, and regulatory bodies.

 

Qualifications:

  • Bachelor's in Healthcare Administration, Business, or related field; MBA, MHA, or advanced degree strongly preferred.
  • 25+ years of progressive leadership in healthcare payer domain, leading product or engineering-driven payer transformation.
  • In-depth knowledge of claims adjudication, provider contracting, reimbursement models (FFS / value-based), risk adjustment, and member engagement platforms.
  • Hands-on experience with payer systems (analytics platforms, CRM, adjudication engines), interoperability standards (EDI, FHIR), and data security regulations (HIPAA).
  • Exceptional presence with ability to engage Executive and Board-level stakeholders, negotiate complex payer contracts, and drive thought leadership.

 

Location: Chennai/Hyderabad

Country Code: IN

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