Hiring: Healthcare Transformation Lead Company: Claddagh Resources Location: Minneapolis, MN Job Posted Time: 2026-09-15 12:20:13 Target Skills & Keywords : Medicaid, Medicare, Prior Authorization, Stakeholder Management About the job Experience: •23+ Years in Strategic Talent Acquisition Required Skills: •Define and lead AI-led payer transformation visions spanning claims modernization, prior authorization, payment integrity, contact center, clinical transformation, and value-based care •Identify high-impact AI and GenAI use cases such as autonomous claims adjudication and conversational AI for member and provider interactions, and drive their incubation and scaling •Partner with delivery and engineering teams on payer platform modernization strategies, including core admin systems and digital front door •Lead large deal pursuits with domain-led solutioning and proposal input, and run AI transformation workshops as an industry authority •Build reusable payer frameworks, solution accelerators, and reference architectures, and publish whitepapers and points of view Qualifications: •Deep domain expertise and leadership in US healthcare payer, with techno-functional command of Medicare, Medicaid, and Commercial lines of business •A proven track record leading end-to-end payer transformation programs •Strong CXO-level stakeholder management and advisory experience with US payer clients •Comprehensive expertise in payer operating models and data flows across claims, provider, membership, and care management •Knowledge of regulatory mandates and interoperability requirements •Candidates must be authorized to work in the United States without sponsorship. Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!