About the Role
We are seeking a highly accomplished Senior Healthcare Engagement & Delivery Leader with deep expertise in the Payer and Provider ecosystem, digital transformation, and global delivery management. This role will lead large-scale healthcare programs, drive end-to-end business transformation, manage strategic client relationships, and own P&L responsibilities for multimillion-dollar accounts.
The ideal candidate is a visionary leader with a strong track record in BPaaS delivery, healthcare operations, outsourcing strategy, and growth-driven account management across Fortune 500 organizations.
Key Responsibilities
Strategic Leadership & Growth
- Drive business growth, account expansion, and digital transformation initiatives within healthcare payer and provider organizations
- Own and manage P&L for large-scale engagements ($50M–$80M+), ensuring revenue growth and profitability
- Develop and execute go-to-market strategies and transformation roadmaps
Client & Stakeholder Management
- Build and manage C-level stakeholder relationships across Fortune 100 healthcare clients
- Serve as a trusted advisor delivering innovative, customer-centric solutions
- Drive client satisfaction (NPS), retention, and long-term partnerships
Solutioning & Transformation
- Lead end-to-end solution lifecycle including strategy, pricing, value propositions, contract negotiations, and closures
- Design and implement outsourcing and BPaaS solutions across healthcare operations
- Drive intelligent automation, process optimization, and digital innovation initiatives
Delivery & Operational Excellence
- Oversee global delivery teams (800+ resources) across multiple geographies
- Manage end-to-end healthcare operations including:
- Claims processing
- Enrollment & benefits administration
- Provider data management & credentialing
- Appeals & call center operations
- Ensure adherence to SLAs, regulatory compliance (CMS, Medicaid, Medicare), and operational KPIs
Transformation & Innovation
- Lead automation and digitization programs improving efficiency and reducing costs
- Establish and grow Centers of Excellence (CoEs) for healthcare offerings
- Drive compliance with federal and state regulatory changes
Required Skills & Qualifications
- Bachelor’s or Master’s degree in Healthcare, Business, Technology, or related field
- 20+ years of experience in Healthcare (Payer/Provider domain)
- Proven expertise in:
- Healthcare BPaaS & outsourcing models
- Digital transformation & automation
- Solution design & presales
- Contract negotiation & pricing strategy
- Strong experience managing large-scale P&L portfolios ($50M+)
- Deep knowledge of:
- Medicaid, Medicare Advantage, and commercial payer operations
- Claims lifecycle, enrollment, provider lifecycle management
- Demonstrated success in managing global delivery teams and multi-geography operations
Preferred Skills
- Certifications: Six Sigma, AHIMA, or equivalent
- Experience with platforms like Facets, NASCO, HealthEdge, SAP, PeopleSoft
- Exposure to interoperability, CMS audits, and regulatory transformations
- Experience in healthcare automation and AI-driven solutions
Key Competencies
- Strategic thinking and executive leadership
- Strong financial acumen and P&L ownership
- Exceptional communication and negotiation skills
- Customer-centric mindset
- Ability to drive innovation and large-scale transformations
- Cross-cultural team leadership and collaboration
Pay: $180,000.00 - $220,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Paid time off
- Vision insurance
Work Location: Remote
