Senior Director, AI-Powered Claims Pricing

Zelis

Morristown (NJ)

Hybrid

USD 169,000 - 214,000

Full time

14 days+

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Job summary

Zelis seeks a Senior Director of Pricing Solutions to lead strategic initiatives improving the performance, efficiency, scalability, and future readiness of the Claims Pricing & Revenue organization. This role collaborates with leadership to turn priorities into actionable roadmaps, ensure measurable outcomes, and drive continuous improvement across pricing, repricing, and negotiations.

Initially an senior IC with potential to grow into people leadership, the role emphasizes AI, automation,

Qualifications

Bachelor’s degree (or commensurate experience) in a related field.
12+ years in healthcare operations, claims pricing, reimbursement, payment integrity, revenue operations, consulting, transformation, or related fields.
Proven track record leading cross-functional initiatives with measurable operational or financial outcomes.
Knowledge of healthcare claims pricing, repricing, reimbursement, negotiations, payer operations, or related revenue workflows.
Experience identifying and implementing automation, AI, workflow, or technology-enabled operational improvements.
Experience developing performance measures, dashboards, business cases, or benefit-realization plans.
Experience influencing senior leaders and driving decisions in a matrixed environment.
Experience managing complex client escalations; leadership to build a future team.
People-leadership experience is beneficial but not required at appointment; ability to build and lead a future team.

Responsibilities

Lead strategic initiatives to advance pricing and revenue strategy and improve long-term performance.
Translate priorities into practical roadmaps, milestones, ownership, and measurable outcomes.
Identify opportunities to simplify work, reduce fragmentation, and improve coordination across pricing, repricing, and negotiations.
Evaluate operating practices and recommend changes to improve scalability, quality, and margins.
Lead cross-functional initiatives spanning products, teams, systems, or stakeholders.
Surface risks, dependencies, and tradeoffs to support leadership decisions and prioritization.
Partner to implement high-value AI, automation, and workflow opportunities.
Develop implementation plans with business need, outcomes, and performance measures.
Monitor adoption and results to ensure value delivery.