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Strategic AI & Automation Leadership

• Develop and execute the Health Plan's AI and automation strategy, aligning investments with organizational priorities and measurable business outcomes.

• Establish a multi-year roadmap for AI, machine learning, generative AI, workflow automation, and robotic process automation (RPA).

• Identify opportunities to improve administrative efficiency, operational performance, member experience, provider experience, and cost management through intelligent automation.

• Prioritize initiatives based on business value, implementation complexity, risk, and return on investment.

• Serve as a strategic advisor to executive leadership regarding emerging AI technologies, market trends, and innovation opportunities.

AI Engineering & Solution Delivery

• Lead the design, development, deployment, and scaling of production-ready AI and automation solutions.

• Oversee implementation of automation and AI initiatives across Claims, Prior Authorization, Utilization Management, Provider Operations, Finance, Enrollment, Care Management, Encounters, and Member Services.

• Establish engineering standards, development methodologies, and quality controls that ensure scalable and sustainable delivery.

• Create repeatable frameworks for evaluating, testing, and operationalizing emerging technologies.

Architecture, Platforms & Technology Governance

• Define enterprise architecture standards supporting AI and automation initiatives.

• Establish integration patterns, APIs, data pipelines, orchestration frameworks, observability capabilities, and resiliency standards.

• Lead platform evaluation, selection, implementation, and lifecycle management activities.

• Ensure alignment with enterprise technology strategy and long-term scalability goals.

Responsible AI, Compliance & Risk Management

• Establish enterprise governance frameworks for responsible AI usage.

• Ensure compliance with HIPAA, privacy regulations, security requirements, and organizational policies.

• Implement controls supporting explainability, auditability, model lifecycle management, drift monitoring, and bias mitigation.

• Partner with Compliance, Legal, Risk Management, Privacy, and Security teams to maintain appropriate oversight.

Operational Excellence & Value Realization

• Establish operational support models for AI and automation solutions, including SLAs, incident management, monitoring, release governance, and continuous improvement.

• Develop performance dashboards and executive reporting frameworks.

• Measure and communicate business outcomes associated with AI investments.

• Drive optimization and continuous improvement of deployed solutions.

Executive Partnership & Change Leadership

• Partner closely with operational leaders to identify automation opportunities and drive organizational adoption.

• Lead executive discussions regarding priorities, investments, risks, tradeoffs, and expected outcomes.

• Develop change management strategies supporting implementation and user adoption.

• Translate technical concepts into actionable business recommendations for executive audiences.

Talent Leadership & Organizational Capability Building

• Build, lead, and develop a high-performing team of AI engineers, automation developers, data engineers, solution architects, and technical leaders.

• Foster a culture of innovation, accountability, continuous learning, and collaboration.

• Develop succession plans and technical career pathways.

• Elevate organizational capabilities in AI engineering, automation, and digital transformation.

Success Measures

Within the first 12-24 months, the Executive Director will be expected to:

• Develop and gain executive alignment on a comprehensive AI and automation roadmap aligned with Health Plan priorities.

• Establish a sustainable AI Engineering & Process Automation function with strong governance, architecture standards, and operational processes.

• Successfully deploy multiple production AI and automation solutions that deliver measurable operational and financial improvements.

• Reduce administrative burden, manual work effort, claim pend volumes, turnaround times, and operational inefficiencies across targeted functions.

• Implement responsible AI governance frameworks that ensure compliance with security, privacy, regulatory, and ethical standards.

• Deliver measurable value realization through improvements in productivity, accuracy, cost avoidance, quality, and member/provider experience.

• Build executive dashboards and reporting frameworks that demonstrate adoption, performance, ROI, and business impact.

• Recruit, develop, and retain a high-performing team capable of scaling AI and automation capabilities across the enterprise.

• Establish trusted advisory relationships with operational and executive leaders and become the organization's recognized leader in AI-driven transformation.

• Position Presbyterian Health Plan as a leader in intelligent automation and responsible AI adoption within the healthcare payer industry.

• 12+ years of progressive technology leadership experience in software engineering, AI, automation, digital transformation, or enterprise technology delivery.

• 7+ years leading managers, technical leaders, and enterprise-scale technology programs.

• Demonstrated executive accountability for AI, automation, engineering, or digital transformation initiatives.

• Proven success building and scaling high-performing engineering, AI, or automation organizations.

• Experience influencing executive stakeholders and leading enterprise transformation initiatives.

• Demonstrated track record establishing strategy and governance while delivering measurable business outcomes.