Sr. Director, Business Rule Modernization

The Sr. Director, Business Rule Modernization leads the capability enablement streams for claims adjudication rules across all lines of business, utilizing an Assess, Improve, and Monitor methodology to evaluate, modernize, and sustain rule accuracy. This role directs a team to build a centralized rules registry, rationalize fragmented logic, and implement low-code and AI-enabled automation to reduce manual configuration. The position requires close collaboration with Claims Operations, Payment Integrity, Policy and Contract Management, and Information Technology to ensure rules remain accurate, auditable, and scalable within the Core Admin Platform transformation.