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Pegasystems, Inc. Director, Industry Principal - Healthcare Claims in Pierre, South Dakota

Director, Industry Principal - Healthcare Claims

Job Category: Business Operations

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Meet Our Team:

The Industry Markets (IM) team defines and articulates the global go-to-market stragegy for the industries that Pega serves. They partner with, and influence, the product General Managers. They empower the sales teams through the creation of repeatable sales assets, egaging as subject matter experts with strategic clients and partners, and serving as industry thought leaders at global events and in the press. Pega currently has a broad base of healthcare customers including nearly all of the top 20 health payers in the U.S. Focused on payer operations, Pega’s Healthcare Core Administration Markets Team provides subject matter expertise and thought leadership that supports, defines and engages appropriate resources, market strategies and relevant product offerings to create and execute successful go to market strategies that increase win rates for Pega's Healthcare vertical and tremendous success for our clients.

Picture Yourself at Pega:

Perennially classified as market leader in numerous technology categories by top analysts, Pegasystems' Intelligent Automation rankings include high marks for Robotic Process Automation (Gartner), Low-Code Application Platform (Gartner), Digital Decision Management (Forrester), real-time interaction management (Forrester), and Digital Process Automation for Deep Deployments Forrester). In this hands-on mind and market share-building role, you represent the voice of our clients in driving business success. Your deep expertise in healthcare core administration business operations and software, primarily member operations (enrollment, billing, reconciliation) provider operations (contracting, credentialing, on-boarding), product and benefit operations and claims operations,will enable you to help our sales & consulting teams, and our partners, sell & provide our world class technology as the solution to handle business critical transformation projects for our clients.

What You'll Do at Pega:

  • As the "voice of the customers", you will apply your expertise to creating content and enablement that amplifies the success of our diverse cross-functional team.

  • Understand Pega's core administration capabilities and identify industry problems where we can offer outstanding value to our clients.

  • Document those use cases and solutions across all areas of the business, including:

  • Develop world class sales and marketing content to support omni-channel selling that transforms our growth and ability to engage clients and partners across digital, virtual, or in-person engagements.

  • Define solution-demonstration use cases and provide vision and guidance to sales consulting and development resources.

  • Empower sales and consulting teams with enablement that inpires confidence in relevant go-to-market and engagement strategies, market offerings, and supporting artifacts, to drive and close sales pipeline goals.

  • Join the team in sales pursuits by the way of personalizing / extending demo scripts, competitive intelligence, RFXs, tenders, participation in presentations, and selection of relevant customer references.

  • Represent Pega at relevant events and meet-ups to raise brand awareness and promote Pega capabilities in the healthcare space (speaking to Pega’s full healthcare portfolio when necessary)

  • Establish product roadmaps for core administration and work with Pega product teams to prioritize and execute on the delivery of needed functionality.

Who You Are:

  • A healthcare payer operations expert with 10+ years working within a health plan where you had various positions and a hands on role in member and provider operations and a clear understanding of health insurance products, their financing, current trends/regulations, and typical obstacles for efficient core administration execution.

  • A healthcare IT expert with 10+ years working for or with US healthcare software, including specific knowledge of leading healthcare operations platforms and typical transactions including claims adjudication, member enrollment & billing (health exchange requirements, CMS enrollment specs) and provider lifecycle management.

  • Exceptional at communicating and enabling others including the creation of sales assets and other tools to provide a path for our sales teams and partners to discover and close business.

  • A thought leader, with exceptional consulting and advisory skills and strong interpersonal acumen with proven experience working closely with sales function within technology companies.

  • Focused on driving business outcomes, and equally conversant/familiar with IT and business issues.

What You've Accomplished:

  • You've had success leading a cross functional. matrixed team, working across skill sets and experience to align and deliver on significant group commitments in high-growth and team orientated environments.

  • You've led transformational projects for one or more payers associated with claims, benefits, or core operations.

  • You've sponsored notable innovation and outcomes for your clients and business partners.

  • You've been the trusted executive advising you business and IT partners on solutions with most impact to their objectives.

Pega Offers You:

  • Gartner Analyst acclaimed technology leadership across our categories of products.

  • Continious learning and development opportunities.

  • An innovative, inclusive, agile, flexible, and fun work environment.

  • Competitive global benefits program inclusive of pay + bonus incentive, employee equity in the company.

  • An opportunity to work with leaders in the healthcare market to take on their most pressing challenges.

Job ID: 12000

As anand Affirmative Action employer, Pegasystems will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, veteran or disability status, or any other category protected by law.

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