Vice President, Payment Integrity AI Solutions

🕒 May 19

🤠 Texas – Remote

🤠 Texas – Remote

💵 $192k - $275k / year

⏰ Full Time

🔴 Lead

🤖 Artificial Intelligence

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Own end-to-end business-level product management for Payment Integrity AI solutions, including roadmap planning, prioritization, feature definition, delivery coordination, adoption, and performance measurement • Lead the strategy and execution for AI-powered capabilities, including AI Assistant, AI Reviewer, Policy Healthcheck, AI foundational agents, and domain-specific Payment Integrity agents • Partner with Technology, Product, Analytics, Operations, and Delivery teams to translate business needs into scalable AI capabilities that improve audit performance, operational efficiency, and client outcomes • Work with Cost Containment Operations leaders to develop new hypotheses that drive material revenue growth, reduce operating costs, increase audit throughput, improve accuracy, and enable double-digit year-over-year growth • Develop prototypes, pilots, and minimum viable products to validate market demand, internal usability, functional design, and feature effectiveness • Ensure go-to-market readiness for new AI solutions, including sales enablement, value proposition development, training, implementation readiness, delivery models, and adoption plans • Define success metrics for AI solutions, including revenue impact, adoption, operational efficiency, user productivity, audit quality, client value, and return on investment

🎯 Requirements

• Master’s degree in Computer Science, Data Science, AI, or a related field • 15+ years of experience in AI/ML, with at least 7 years in leadership roles focused on implementing and scaling AI solutions • Demonstrated success in delivering AI products in healthcare or other regulated industries • Expertise in integrating AI technologies, including GenAI, into complex systems and ensuring their operational viability • Strong project management skills with the ability to manage budgets, timelines, and resources effectively • Excellent communication and stakeholder management skills to align AI initiatives with business priorities

🏖️ Benefits

• Generous, flexible vacation policy • Educational assistance • Comprehensive health benefits • 401(k) employer match • Leadership and technical development academies