Automation & Process Transformation Lead - Health

Shape the Future of Health Insurance Operations

We are transforming the way healthcare operations are delivered through automation, artificial intelligence, and data-driven decision making. We are seeking an experienced Automation Process Lead to drive our automation and digital transformation agenda across Health Operations.

This is a strategic role for a forward-thinking professional who combines operational excellence, healthcare expertise, and technology acumen to deliver scalable process improvements, enhanced customer experiences, and measurable business value.

If you are passionate about innovation, operational transformation, and leveraging AI to redefine healthcare administration, we would love to hear from you.

As the Automation Process Lead, you will be responsible for leading and executing the automation strategy across Health Operations while ensuring regulatory compliance, operational excellence, and sustainable value creation.

• Develop and execute the Health Operations automation roadmap aligned with business objectives and KPIs.
• Identify, prioritize, and implement high-impact automation opportunities across Claims and Medical Approvals processes.
• Lead end-to-end automation initiatives that improve efficiency, accuracy, and service quality.
• Establish strong automation governance, controls, and monitoring frameworks.
• Drive process re‑engineering and standardization initiatives before automation deployment.

• Increase Straight Through Processing (STP) rates across key operational processes.
• Reduce manual touchpoints and eliminate process inefficiencies.
• Improve turnaround times (TAT) and optimize cost per transaction.
• Monitor and enhance compliance, quality, and operational performance metrics.
• Lead continuous improvement initiatives to deliver sustainable operational gains.

• Collaborate closely with Operations, IT, Digital, and Data teams to implement automation solutions.
• Support the development and optimization of Rules Engines, AI-enabled adjudication, and workflow automation solutions.
• Lead User Acceptance Testing (UAT), validation activities, and accuracy monitoring.
• Analyze operational data and generate insights through dashboards and business intelligence tools.
• Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

• Act as the key liaison between Operations, IT, and Digital stakeholders.
• Conduct process mapping, gap analysis, and workflow assessments.
• Maintain up-to-date operational guidelines and process documentation.
• Ensure adherence to relevant healthcare insurance regulations and compliance requirements.
• Provide operational feedback and support for complex claims and workflow-related queries.
• Coordinate workflows effectively to meet agreed service levels and deadlines.

• Support and coach junior team members through structured training and ongoing feedback.
• Foster a culture of innovation, continuous learning, and operational excellence.

• 5-8+ years of experience in Health Insurance, TPA, or Healthcare Operations.
• Minimum 5 years of practical medical insurance experience within a reputable insurer, broker, healthcare payer, or TPA environment.
• Proven experience leading process improvement, automation, or digital transformation initiatives.
• Hands‑on experience with Automation Platforms, RPA solutions, Rules Engines, and workflow technologies.

• Strong analytical capabilities and experience using operational data to drive decisions.
• Advanced proficiency in Power BI, Alteryx, and dashboard development.
• Advanced Excel skills and strong command of MS Office applications.
• Coding certification or demonstrated technical capability in automation-related technologies.
• Experience working with AI‑enabled solutions, machine learning applications, or intelligent automation is highly desirable.

• Exceptional communication and stakeholder management skills.
• S…