Principal Consultant - Healthcare Payer

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Principal Consultant – Healthcare Payer

Fractal Analytics is a strategic AI partner to Fortune 500 companies with a vision to power every human decision in the enterprise. Fractal is building a world where individual choices, freedom, and diversity are the greatest assets. An ecosystem where human imagination is at the heart of every decision. Where no possibility is written off, only challenged to get better. We believe that a true Fractalite is one who empowers imagination with intelligence. And that it will be such Fractalites that will continue to build the company for the next 100 years.

Role Overview

We are seeking a collaborative, visionary, and results-driven Principal Consultant to strengthen our Healthcare Payer AI consulting team. This is a leadership role that fuses deep AI and GenAI expertise with healthcare domain knowledge to solve the industry's most complex challenges. You will be responsible for leading high-impact engagements, developing AI-enabled products and solutions, and influencing strategic priorities at the client and practice levels.

You Will Be Responsible For

• Drive the execution of our payer segment strategy through the application of advanced AI and GenAI
• Build, manage, and deepen executive relationships with key healthcare payer clients
• Design and deliver GenAI-powered transformation programs that improve care delivery, reduce cost of care, and enhance member engagement
• Develop proprietary frameworks and accelerators using LLMs, knowledge graphs, and agentic AI systems
• Mentor cross-functional teams and evangelize the responsible use of AI in healthcare
  
  
  

Key Responsibilities

• Partner with payer clients (e.g., health plans, PBMs, ASOs) to solve strategic and operational challenges using AI/GenAI
• Lead large-scale AI consulting engagements from scoping to value realization
• Design and deploy AI/GenAI solutions in areas such as member engagement, care management, utilization management, risk adjustment, and fraud detection
• Translate payer business needs into scalable, secure, and compliant AI/GenAI architectures and products
• Lead the development of GenAI use cases, prompt engineering frameworks, agent-based workflows, and governance models
• Collaborate with data scientists, AI engineers, and product managers to rapidly build and iterate on MVPs
• Develop and own executive-ready collateral to support business development and thought leadership
• Stay abreast of the latest trends in GenAI, healthcare policy, and payer business models
  
  
  

Who You Are

• A healthcare-savvy AI leader who bridges business strategy with cutting-edge AI solutions
• A trusted advisor to C-suite and senior stakeholders at health plans and PBMs
• A builder and innovator, passionate about transforming healthcare through GenAI
• A strategic thinker with strong commercial acumen and delivery rigor
• A hands-on mentor who cultivates high-performing, cross-functional teams
• Solution architect who can conceptualize, build, and deliver technology-driven business solutions
  
  
  

Qualifications

• Bachelor's degree in Computer Science, Engineering, Data Science, Healthcare Administration, or related field (Master's or MBA preferred)
• 12+ years of experience in healthcare consulting, technology delivery, or innovation roles, with at least 5 years focused on AI and/or GenAI
• Strong understanding of the U.S. healthcare payer ecosystem-commercial, Medicare, Medicaid-and associated data systems (claims, EMR, HEDIS, etc.)
• Proven experience designing and delivering AI/ML and GenAI solutions for health plans, including hands-on exposure to:
• Large Language Models (LLMs), Prompt Engineering, Retrieval-Augmented Generation (RAG), Agentic Workflows
• NLP/NLU for clinical and payer data
• Cloud platforms (Azure, AWS, GCP) and MLOps frameworks
• Strong technical fluency to collaborate with engineering and data science teams while influencing non-technical stakeholders
• Experience in responsible AI governance, data privacy (HIPAA), and regulatory compliance
• Exceptional communication, storytelling, and executive presence
  
  
  

Nice to Have

• Experience with GenAI tools and platforms (OpenAI, Anthropic, Vertex AI, Bedrock, etc.)
• Exposure to healthcare interoperability standards (FHIR, HL7)
• Prior experience with AI product development or commercializing AI accelerators
• Experience with consulting providers and payviders
  
  
  

Pay

The wage range for this role considers the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Fractal, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is: $200,000 to $250,000.

Benefits

As a full-time employee of the company or as an hourly employee working more than 30 hours per week, you will be eligible to participate in the health, dental, vision, life insurance, and disability plans in accordance with the plan documents, which may be amended from time to time. You will be eligible for benefits on the first day of employment with the Company. In addition, you are eligible to participate in the Company 401(k) Plan after 30 days of employment, in accordance with the applicable plan terms. The Company provides for 11 paid holidays and 12 weeks of Parental Leave. We also follow a "free time" PTO policy, allowing you the flexibility to take time needed for either sick time or vacation.

Fractal provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

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Fractal Analytics is a strategic AI partner to Fortune 500 companies with a vision to power every human decision in the enterprise.