Executive Director, Adjudication Software Engineering & Transformation
Core
Lead software engineering and transformation of the adjudication ecosystem (Eligibility, Member Data, Drug, Pharmacy) to modernize data services and enable 'Adjudication as a Service'.
Role type
Executive Director, Adjudication Software Engineering & Transformation
Builds
Modernized adjudication data services and 'Adjudication as a Service' platform across cloud and legacy systems.
Domain
Healthcare IT / Insurance Adjudication
Deliverable
production ML models | product features | infrastructure
Required skills
Cloud engineering, Application/system architecture, Cross-functional team leadership, Strategic planning, Budget management, AI integration, Legacy platform management, Vendor management, Regulatory compliance
Preferred skills
Mainframe/AS400 experience, IT Service Management (ITSM), Agile/SCRUM methodologies, Product-led transformation, CMS Medicare regulations knowledge
Technologies
Azure, GCP, IBMi, Mainframe, AS/400
Responsibilities
Set and execute strategy for modernizing adjudication data services; Lead and scale a high-performing software engineering organization; Partner with stakeholders to translate business processes into implementation plans; Innovate by adopting AI into business processes; Manage overall delivery, budget, and resources; Ensure compliance with company policies and regulations.
Seniority
Executive Director, 12+ years experience