Director, Payer Systems and Applications Technology Consulting - Remote

Eden Prairie, Minnesota (United States) Overview In this role, you advise client organizations on payer platform transformations, shaping architectures and roadmaps to modernize core systems. You'll lead multi-disciplinary delivery across claims, enrollment, billing and related capabilities, ensuring value delivery and stakeholder alignment. You'll work with executive sponsors to drive AI-enabled improvements and scalable programs that impact cost, quality and growth. The opportunity combines healthcare domain expertise with cutting-edge AI and automation to improve outcomes. Compensation / Benefits comprehensive benefits package incentive and recognition programs equity stock purchase 401k contribution remote work flexibility telecommuter policy Responsibilities Act as trusted advisor to client executives and delivery partners, building durable relationships Assess current-state processes, data, architecture and operating models to identify transformation priorities Formulate technical solution architectures for payer platform implementation, migration, modernization, optimization and integration Build consensus and translate technical choices into business implications and roadmaps Lead or oversee modernization programs for core payer platforms (e.g., TriZetto Facets, HealthRules Payer, QNXT, Epic, Tapestry, ikaSystems) Guide work across claims, enrollment, billing, benefits, provider, pricing, customer service and related payer capabilities with integrations to other systems Own end-to-end technical delivery for complex payer transformations with accountability for outcomes and quality Establish delivery governance, integrated plans, decision rights, architecture oversight, quality controls and executive reporting across multiple workstreams Manage scope, budget, schedule, resources, risks and changes; address delivery variance and enable fact-based decisions Serve as senior escalation point to remove blockers and lead recovery planning Lead multidisciplinary teams including architects, engineers, data/integration, testers and program managers Apply Agile, SAFe or hybrid delivery as appropriate to the client environment Demonstrate working knowledge of AI, generative AI, intelligent automation and analytics in healthcare payer operations Identify and prioritize practical AI opportunities across claims, benefits, provider data, enrollment, customer service and program delivery Help clients develop AI-enabled transformation roadmaps with measurable adoption outcomes Participate in pursuits, solutioning, proposals and negotiations; expand accounts through differentiated capabilities Contribute to sales objectives with demonstrated account growth as applicable Advance service offerings, reusable assets and thought leadership in payer platform transformation and AI-enabled operations Lead creation and quality review of client-facing deliverables and executive materials Key requirements 10+ years in healthcare (insurance, payer operations, health tech or management consulting) 5+ years of healthcare technology consulting supporting payer organizations 5+ years of leadership with direct client accountability 5+ years of experience with at least one major payer platform (e.g., TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems) 1+ year evaluating AI opportunities and risk for automation in healthcare or regulated industries leadership stakeholder management communication payer platform expertise (TriZetto Facets, HealthRules Payer, QNXT, Epic Tapestry, ikaSystems) AI, generative AI, intelligent automation program/project management ( Agile, SAFe, cloud, architecture)