Director AI & Innovation

Our Head of AI and Innovation leads the design and execution of artificial intelligence, automation, and emerging technology strategy within the Healthcare Payer space. This role drives enterprise innovation to enhance member engagement, improve administrative efficiency, optimize clinical and operational outcomes, and support value-based care models. Partnering with IT, Data, Operations, and Business leaders, this leader ensures that AI and automation solutions are responsible, compliant, and aligned with the organization’s strategic goals.

This role has preference for flexible hybrid location (onsite Meridian Idaho campus, and work-from-home); there may be opportunity for fully remote work within a mutually acceptable location. #LI-Remote; #LI-Hybrid

Key Responsibilities

Strategic Leadership

• Develop and execute an enterprise AI and innovation roadmap aligned with payer strategy, digital transformation, and regulatory frameworks.

• Serve as a thought leader on how AI, machine learning (ML), and automation can improve claims accuracy, utilization management, provider experience, member service, and other areas of the business.

• Cultivate a culture of innovation across technology and business functions, emphasizing measurable business impact and responsible experimentation.

AI & Automation Enablement

• Lead the design, development, and deployment of AI/ML and intelligent automation (e.g., NLP, RPA, GenAI, Agentic) solutions across payer functions such as claims adjudication, call centers, prior authorization, and analytics.

• Partner with Enterprise Data and IT to operationalize models on modern data platforms and ensure scalability and governance.

• Build an AI Center of Excellence (CoE) to standardize best practices, accelerate model deployment, and support business-led innovation.

Innovation Management

• Identify high-value opportunities to modernize processes and improve outcomes for members, providers, and internal teams.

• Manage a structured innovation pipeline — from ideation and proof of concept to pilot and enterprise scaling.

• Collaborate with strategic vendors, startups, and academic partners to explore new technologies (e.g., predictive analytics, GenAI, digital twins, conversational AI).

Governance & Compliance

• Define and implement frameworks for ethical, explainable, and compliant AI use consistent with HIPAA, CMS, and state regulatory requirements.

• Partner with Legal, Compliance, and Risk functions to ensure AI models and innovation initiatives meet privacy, fairness, and transparency standards.

Leadership & Talent Development

• Build and lead a cross-functional team of AI engineers, data scientists, and innovation strategists.

• Champion workforce AI literacy and innovation training across departments.

• Promote diversity of thought and inclusive design in innovation initiatives.

Qualifications

Education & Experience

• Bachelor’s degree in Computer Science, Engineering, Data Science, or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college).

• 10+ years' experience in technology and innovation, to include leadership preferably within healthcare or regulated industries.

• Proven success deploying Digital or AI/automation at scale.

Skills & Competencies

• Strong knowledge of Digital/AI/ML platforms, automation technologies (RPA, NLP, GenAI), and data architectures.

• Ability to translate emerging technologies into operational and clinical value.

• Understanding of healthcare data standards (HIPAA, FHIR, HL7) and regulatory environments.

• Excellent leadership, communication, and collaboration skills.

• Strategic thinker with a bias for measurable outcomes and innovation scalability.

Key Success Metrics

• Tangible ROI from AI and innovation initiatives (e.g., cost reduction, accuracy improvement, experience enhancement).

• Increased automation and AI adoption in claims, service, and operations.

• Accelerated cycle time from ideation to implementation.

• Established AI governance framework ensuring compliant and ethical use.

• Strengthened culture of innovation across business and IT.

As of the date of this posting, a good faith estimate of the current pay range is: $150,000 - $225,000. The position is eligible for an annual incentive bonus (variable depending on company and employee performance). The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, internal equity, geography, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.