Job Summary:

The Claims AI Business Analyst IV is responsible for driving end-to-end process transformation initiatives across Claims Operations by leveraging automation and artificial intelligence (AI) to improve efficiency, reduce costs, and enhance quality. This role operates as both a hands-on analyst and initiative owner, with accountability for the full lifecycle of work including intake, prioritization, design, implementation, and sustained value realization. They serve as the primary owner of the Claims Operations automation and AI pipeline, ensuring alignment to business priorities and measurable return on investment.

Essential Functions:
- Establish and maintain a structured pipeline/backlog aligned to business priorities and ROI potential.
- Partner with leadership to assess demand, size opportunities, and prioritize work based on impact and feasibility.
- Serve as liaison between business, IT, and AI teams to align intake with enterprise processes.
- Lead cross-functional initiatives from intake through implementation and post-production stabilization.




- Drive stakeholder alignment, decision-making, and accountability through influence without direct authority.
- Ensure initiatives are clearly scoped, sequenced, and delivered against defined timelines and outcomes.
- Conduct detailed analysis of workflows to identify inefficiencies, bottlenecks, and automation opportunities.
- Apply process improvement methodologies (e.g., process mapping, workflow redesign, root cause analysis).
- Develop current-state and future-state workflows to improve throughput, quality, and scalability.
- Evaluate processes for automation and AI applicability (e.g., GenAI, RPA, workflow tools, decision engines).
- Translate operational challenges into scalable, technology-enabled solutions.
- Partner with Automation and IT teams to define solution approach, feasibility, and implementation strategy.
- Facilitate and lead implementation efforts across Operations, IT, AI teams, an

📌 Claims AI Business Analyst IV (India)
🏢 CareSource
📍 India