Jobs at Brightleaf

Leads the design, development, and production deployment of enterprise AI solutions for clients and internal initiatives. Responsibilities include architecture, coding, generative AI, RAG, agentic workflows, model evaluation, governance, security, monitoring, and integration with cloud and enterprise platforms. The role also develops reusable AI accelerators, advises executives, manages delivery plans, evaluates emerging technologies, and mentors technical teams in a consulting environment.

Delivers claims analytics and post-pay data mining for payment integrity engagements. Identifies incorrect payments and savings opportunities, supports remediation, process improvement, automation, and configuration initiatives, researches reimbursement regulations and market trends, and prepares client-ready recommendations. Requires knowledge of healthcare claims, coding, payment methodologies, payer operations, provider data, and contract pricing, along with advanced Excel and strong analytical and communication skills.

Lead end-to-end Salesforce implementation programs focused on digital transformation. Manage multiple concurrent workstreams (business, technical, data, integrations, testing, deployment), run Agile ceremonies, maintain project plans and governance, coordinate onshore/offshore teams and vendors, manage risks, budgets, and executive stakeholders, and support business development and practice growth.

Supports pharmacy and healthcare consulting engagements by analyzing pharmacy claims, developing operational workflows, researching reimbursement regulations and market trends, identifying business solutions, and contributing to process improvement, automation, and client-ready deliverables. The role requires healthcare and pharmacy benefits knowledge, advanced Excel and PowerPoint skills, clear communication, and data analysis capabilities.

Leads pharmacy consulting initiatives for PBM migrations, system implementations, and pharmacy transformation programs. Analyzes pharmacy and medical drug spend, pricing, reimbursement, claims, formulary strategy, and utilization management to identify cost-saving opportunities. Develops client recommendations, business cases, analytics, reports, and deliverables while supporting automation and workflow improvements. Participates in client meetings, monitors regulatory and market changes, and coaches team members.

Lead network strategy and execution for healthcare payer clients: translate claims and provider data into actionable network optimization, manage teams, present findings to stakeholders, and implement contracting and design solutions to improve cost, quality, and access.

Lead end-to-end healthcare payer digital transformation projects, coordinating cross-functional (onshore/offshore) teams, managing timelines, risks, Agile ceremonies, testing and deployments, stakeholder communications, and post-launch support to modernize claims, customer service, and enterprise systems.

Analyze data and build AI/ML solutions to drive business outcomes. Develop and monitor models, design and evaluate Agentic and Generative AI workflows, apply prompt engineering and responsible AI, use SQL/Python and BI tools, and collaborate with stakeholders to translate insights into action.

Work with clients to analyze data, research market dynamics, build business cases, and deliver client-ready recommendations. Lead and mentor junior team members, develop presentations, manage stakeholders, and support implementation of cost and operational improvements in healthcare payer contexts.

Lead procurement, sourcing, and vendor management initiatives for healthcare payers. Perform spend and category analyses, develop financial models and business cases, support RFPs and contract negotiations, present findings to executives, drive cost and operational improvements, mentor junior staff, and manage client communications and implementation.

Lead consulting engagements for healthcare payers, owning workstreams, analyzing claims and financial data, building business cases, presenting recommendations, mentoring team members, and driving implementation and client relationships to improve cost, operations, and performance.

Deliver Payment Intelligence consulting to health plans by analyzing claims, identifying payment accuracy opportunities, recommending process and automation improvements, researching reimbursement policies, preparing client-ready deliverables, and supporting claims editing and contract configuration initiatives.

Lead client engagements to design, build, and operationalize advanced AI/ML and agentic AI solutions. Develop custom models, prototype agentic workflows, apply responsible generative AI practices, mentor junior data scientists, and translate data insights into measurable business outcomes.

Lead and execute healthcare payer consulting engagements: manage teams, analyze complex claims/pharmacy/financial data, develop analytical strategies and solutions, present findings to clients, mentor staff, manage projects end-to-end, and support client implementations while remaining hands-on in execution.

Lead design and delivery of enterprise Salesforce solutions (Health/Service/Marketing Clouds) for healthcare payers. Architect data models, security, integrations (EHRs/claims), CI/CD, and provide technical leadership, assessments, and stakeholder-facing recommendations.