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Senior Vice President - Product - Payer US Healthcare

Senior Vice President - Product - Payer US Healthcare

People ImpactChennai, India
30+ days ago
Job description

Location : Chennai / Hyderabad.

Key Responsibilities :

Strategic Leadership :

  • Develop and implement a long-range plan for the payer domain-including member engagement, provider contracting, claims integrity, and value-based reimbursement.
  • Drive innovation through data analytics, AI, automation, and predictive modeling.
  • Monitor trends in CMS, ACA, FHIR, HIPAA, and EDI standards, adapting strategy proactively.

Technology & Product Leadership :

  • Partner with product and engineering teams to deploy advanced claims adjudication systems, payment integrity platforms, and member / provider CRM portals.
  • Integrate analytics and predictive risk models to optimize value-based payment programs.
  • Ensure interoperability, FHIR compliance, and robust data privacy / security standards.

    • Operational Excellence :

  • Oversee end-to-end payer technology delivery-claims adjudication workflows, payment post- processing, provider reimbursement models, and customer-facing systems.
  • Drive cross- functional initiatives to reduce administrative costs and minimize claim denials and leakage.

    • Team Leadership & Talent Development :

  • Build and mentor high-performing product, engineering, and project management teams.
  • Cultivate a culture of collaboration, innovation, accountability, and continuous improvement.

    • Stakeholder Management :

  • Engage key external stakeholders : payers, providers, brokers, employers, and regulatory bodies.
  • Collaborate with clinical / population health leaders to align payer strategy with care delivery goals.
  • Represent your organization in industry forums, trade associations, and legislative engagements.

    • Financial & Value Management :

  • Drive financial strategy for payer services, optimizing ROI and reducing medical loss ratio (MLR).
  • Oversee budgets, pricing models, and cost-reduction strategies tied to value-based contracting and digital automation.

    • Qualifications :

  • Education : Bachelor's in Healthcare Administration, Business, or related field; MBA, MHA, or advanced degree strongly preferred.
  • Experience : 25+ years of progressive leadership in healthcare payer domain, leading product or engineering-driven payer transformation.
  • Domain Expertise : Deep knowledge of claims adjudication, provider contracting, reimbursement models (FFS / value- based), risk adjustment, and member engagement platforms.
  • Technical Acumen : Hands-on experience with payer systems (analytics platforms, CRM, adjudication engines), interoperability standards (EDI, FHIR), and data security regulations (HIPAA).
  • Leadership Fit : Track record of building and leading large teams, partnering across executive, clinical, finance, and technology functions.
  • Communication & Influence : Exceptional presence with ability to engage Executive and Board-level stakeholders, negotiate complex payer contracts, and drive thought leadership.

    • (ref : iimjobs.com)

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