Healthcare Enterprise Architect - AI

Position: Healthcare Enterprise Architect - AI
Domain: Healthcare (Claims Processing)
Location: Remote (U.S. Based)
Duration: 1 Year

Job Description:

We are looking for a highly skilled Healthcare Enterprise Architect with deep experience in the health insurance domain, particularly in claims processing, and a strong understanding of AI-driven transformation initiatives. The ideal candidate will lead strategic AI programs that enhance claims processing efficiency, develop enterprise AI roadmaps, and collaborate closely with business and technical stakeholders to drive innovation and automation.

Key Responsibilities:

• Lead AI strategy and roadmap development for large-scale healthcare payer initiatives.
• Design, architect, and implement AI/ML-driven solutions that accelerate claim processing, improve data extraction, and enable human-assisted automation (bots).
• Partner with stakeholders to translate business requirements into AI-enabled architectural solutions.
• Ensure architecture designs comply with industry standards, data regulations, and responsible AI practices.
• Stay current with AI/ML advancements, educate teams on responsible AI use, and evaluate new technologies to strengthen organizational capabilities.
• Collaborate with product, engineering, and data science teams to deliver scalable and impactful AI solutions.
• Prepare and deliver executive-level presentations that clearly communicate architecture and business value.

Required Qualifications:

• Strong understanding of healthcare claims processing, payer-provider models, and related regulatory frameworks.
• 3 4+ years of proven experience in Enterprise Architecture (currently performing this role).
• Familiarity with AI/ML technologies and their application to business use cases - not necessarily hands-on but able to identify where AI adds value.
• In-depth knowledge of cost per claim, industry compliance, and claims lifecycle management.
• Proven experience in AI/ML program leadership, roadmap definition, and architecture design.
• Ability to articulate AI solutions and architectures to executive stakeholders in business-friendly terms.
• Strong collaboration, problem-solving, and communication skills.

Preferred Qualifications:

• 15 20 years of overall IT experience with strong enterprise architecture background.
• 3+ years in AI solution architecture or enterprise AI initiatives.
• Experience leading AI transformations in healthcare payer systems.
• Proficiency in enterprise AI platforms, data integration, and automation frameworks.
• Experience preparing executive-level presentations and driving stakeholder engagement.
• Commitment to ongoing learning and promoting ethical AI adoption.

Important Notes:

• Candidates must highlight AI-related use cases they have resolved (at the project level) and detail how they architected and managed those solutions.
• Candidates should also highlight claims processing experience on the resume (at the project level).
• Submissions must include a brief summary or write-up of the AI use case resolved by the candidate.