Transformation Leader- Healthcare

LOCATION: India/Anywhere

REPORTS TO: Global Transformation Leader, Matrixed to Vertical Heads- Healthcare

KEY INTERFACES: BU CEOs, Vertical Heads, Managing Delivery Partners, Client Partners, CIO, Executive Leadership and Commercial HeadsRole & responsibilities

ROLE SUMMARY AND OVERVIEW

As the Global Transformation Lead for the Healthcare vertical, you will drive strategic, digital, and operational transformation across Healthcare client portfolios. This role focuses on reimagining traditional operations with automation, compliance modernization, AI-powered decision support, and enhanced customer journeysenabling clients to stay resilient, secure, and competitive in a highly regulated environment. We are seeking a Leader to drive innovation, efficiency, and client-centric digital solutions across our Healthcare BPaaS ad IT operations.

The ideal candidate will possess deep domain expertise in healthcare (payer, provider, PBM, life sciences) and hands-on experience in leading digital transformation programs using AI, automation, analytics, and cloud platforms to deliver measurable business outcomes.

KEY RESPONSIBILITIES

1. Strategic Leadership & Transformation:

Define and drive the digital transformation roadmap for the healthcare vertical aligned to business goals, including cost reduction, compliance, quality, and customer experience. Identify and implement next-gen technologies (AI/ML, GenAI, RPA, analytics, cloud, NLP, virtual agents) to automate and optimize front/mid/back-office operations.

Lead innovation programs, PoCs, and transformation engagements for healthcare clients across payer, provider, and PBM segments.

1. Client Engagement & Solutioning:

Partner with client leadership to co-create transformation strategies and embed digital enablers into their healthcare operations. Lead digital solutioning during pursuits and renewals; craft compelling transformation narratives for RFPs and proactive pitches.

Serve as SME for healthcare BPO transformation, working closely with delivery, sales, product, and technology teams.

1. Operational Excellence & Governance:

Drive value realization through robust governance, KPIs, and stakeholder alignment. Collaborate with delivery heads to implement change management across global operations.

Ensure compliance with HIPAA, HITECH, CMS, NCQA, and other regulatory frameworks.

1. Innovation & Ecosystem Development:

Evaluate and onboard emerging technologies, startups, and strategic partners. Build reusable digital assets, accelerators, and industry-relevant transformation playbooks.

Represent the organization in industry forums and build a thought leadership profile. Lead transformation initiatives around claims processing, loan origination, fraud detection, policy servicing, and customer onboarding.

Embed AI and analytics for risk scoring, KYC automation, and hyper-personalized financial customer service.

Collaborate with compliance and risk teams to ensure adherence to evolving global financial regulations (e.g., Basel, FATCA, GDPR).

Redesign operating models to enable 24x7 straight-through processing with high accuracy and trust.

1. Performance & Governance

Define KPIs to measure the success of transformation programs (cost, quality, speed, NPS, etc.). Establish transformation governance frameworks and cadence for program tracking, risk management, and escalation.

Ensure delivery on time, within budget, and to define success criteria.

KEY SKILLS & COMPETENCIES:

• Strong understanding of healthcare processes (claims, enrollment, billing, provider data management, care management, revenue cycle).
• Expertise in digital technologies RPA, AI/ML, GenAI, Conversational AI, low-code platforms, analytics, cloud-based solutions.
• Proven experience in leading large-scale transformation programs in healthcare BPaaS environments.
• Exceptional client-facing skills, commercial acumen, and consultative mindset.
• Ability to manage cross-functional teams and drive outcomes in matrixed environments.
• Strong understanding of healthcare regulations and compliance standards.

QUALIFICATIONS: Education: Masters degree in business administration/degree in healthcare administration, Engineering, or related field; certifications in Lean Six Sigma, PMP, or Change Management preferred.

Experience: 1518+ years of experience in BPO/ITES industry with at least 5 years in a transformation leadership role.

Certifications in digital transformation, healthcare compliance, or process improvement (e.g., Lean, Six Sigma, HIPAA) are a plus.