Program Realization Office (PRO) Lead

Job Description

Experience : 20 - 30 years Location : Hyderabad and Chennai. Overview: The PRO Lead in the US payer domain manages large-scale projects, service delivery, and transformation initiatives. They ensure program success, regulatory compliance, and operational excellence while collaborating with payer clients and internal teams to drive innovation and efficiency. Key Responsibilities: Lead payer program planning, execution, and delivery across claims, member services, and provider networks. Ensure alignment with organizational goals, payer regulations, and client expectations. Develop program roadmaps, budgets, and resource plans. Monitor risks, issues, and dependencies, escalating as needed. Manage service frameworks, SLAs, KPIs, and continuous improvement initiatives. Drive digital transformation, automation, and modernization projects. Use technologies like AI, RPA, and analytics to improve payer processes. Act as the main client and stakeholder contact. Build strong payer relationships, identify new opportunities, and establish governance. Report on program performance, risks, and financials. Lead and mentor teams of project managers and specialists. Ensure all activities meet healthcare compliance standards (HIPAA, HITECH, CMS). Experiences Required: Bachelor’s or master’s in healthcare, business, or related fields. 15+ years in large-scale payer program management and operations. Deep knowledge of payer systems, claims, provider, and regulatory environments. Skilled in project management tools and frameworks (Agile, Waterfall, JIRA). Preferred Skills: PMP, ITIL, Lean Six Sigma, or SAFe certifications. Experience with payer technology, regulations, and digital/automation projects. Key Attributes: Strategic, problem-solving, and decision-making mindset. Strong leadership and stakeholder management skills. Results-driven with a focus on high-quality outcomes. This role offers a leadership opportunity to advance payer programs, promote innovation, and enhance healthcare delivery for members. Show more Show less