[Remote] Healthcare Consultant

Note: The job is a remote job and is open to candidates in USA. HCLTech is seeking a highly accomplished Senior Healthcare Engagement & Delivery Leader with deep expertise in the Payer and Provider ecosystem, digital transformation, and global delivery management. This role will lead large-scale healthcare programs, drive end-to-end business transformation, manage strategic client relationships, and own P&L responsibilities for multimillion-dollar accounts.

Responsibilities

• Drive business growth, account expansion, and digital transformation initiatives within healthcare payer and provider organizations
• Own and manage P&L for large-scale engagements ($50M–$80M+), ensuring revenue growth and profitability
• Develop and execute go-to-market strategies and transformation roadmaps
• Build and manage C-level stakeholder relationships across Fortune 100 healthcare clients
• Serve as a trusted advisor delivering innovative, customer-centric solutions
• Drive client satisfaction (NPS), retention, and long-term partnerships
• Lead end-to-end solution lifecycle including strategy, pricing, value propositions, contract negotiations, and closures
• Design and implement outsourcing and BPaaS solutions across healthcare operations
• Drive intelligent automation, process optimization, and digital innovation initiatives
• Oversee global delivery teams (800+ resources) across multiple geographies
• Manage end-to-end healthcare operations including: Claims processing, Enrollment & benefits administration, Provider data management & credentialing, Appeals & call center operations
• Ensure adherence to SLAs, regulatory compliance (CMS, Medicaid, Medicare), and operational KPIs
• Lead automation and digitization programs improving efficiency and reducing costs
• Establish and grow Centers of Excellence (CoEs) for healthcare offerings
• Drive compliance with federal and state regulatory changes

Skills

• Bachelor's or Master's degree in Healthcare, Business, Technology, or related field
• 20+ years of experience in Healthcare (Payer/Provider domain)
• Proven expertise in: Healthcare BPaaS & outsourcing models, Digital transformation & automation, Solution design & presales, Contract negotiation & pricing strategy
• Strong experience managing large-scale P&L portfolios ($50M+)
• Deep knowledge of: Medicaid, Medicare Advantage, and commercial payer operations, Claims lifecycle, enrollment, provider lifecycle management
• Demonstrated success in managing global delivery teams and multi-geography operations
• Certifications: Six Sigma, AHIMA, or equivalent
• Experience with platforms like Facets, NASCO, HealthEdge, SAP, PeopleSoft
• Exposure to interoperability, CMS audits, and regulatory transformations
• Experience in healthcare automation and AI-driven solutions

Benefits

• Performance-based bonuses subject to company policies
• Medical, dental, vision, pharmacy, life, accidental death & dismemberment, and disability insurance
• Employee assistance program
• 401(k) retirement plan
• 10 days of paid time off per year (some positions are eligible for need-based leave with no designated number of leave days per year)
• 10 paid holidays per year

Company Overview

Company H1B Sponsorship