Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive advantages and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

We are seeking a Senior Consultant - Business Systems (Salary Grade 28) to lead and deliver complex initiatives within Payment Integrity (PI) and Defensive AI. This role operates as a senior individual contributor and domain SME, driving end-to-end solutioning across business, data, and technology ecosystems.

You will play a critical role in shaping AI-driven detection strategies, claims integrity solutions, and enterprise system enhancements, ensuring measurable impact on cost savings, accuracy,



and risk mitigation.

Primary Responsibilities:
- Strategic Business AI Requirements Leadership
- Lead end-to-end requirements lifecycle across complex, cross-functional initiatives
- Translate business problems into advanced analytics, rule-based, and AI-driven solutions
- Define solution scope, functional architecture, and non-functional requirements
- Partner with product and engineering to influence solution feasibility and design decisions
- Defensive AI Payment Integrity Solutioning
- Design and enable FWA detection strategies, signals, and intelligence frameworks
- Translate business scenarios into pre-pay/post-pay intervention logic and workflows
- Partner with data science teams on model design inputs, feature definition, and validation frameworks
- Identify systemic gaps and lead initiatives to improve detection accuracy and coverage
- End-to-End Solution Design Delivery Ownership
- Lead

📌 Senior Consultant Business Systems (Bengaluru)
🏢 Optum
📍 Bengaluru