[Hiring] Executive Healthcare Claims Transformation Consultant @L R S

Role Description

LRS Consulting Services is seeking an experienced Executive Healthcare Claims Transformation Consultant for a remote consulting opportunity with our healthcare client in the Chicago metro area!

This individual will lead a large-scale enterprise healthcare administration transformation involving the migration from Harvard Pilgrim health plan administration processes to Aetna-based administration and claims operations. They will serve as the strategic leader responsible for planning, governing, and executing all aspects of the transition, while partnering directly with executive leadership, operational teams, and vendor partners. This is a highly visible consulting engagement responsible for ensuring successful migration, operational continuity, claims integrity, regulatory compliance, and executive-level governance throughout the transformation lifecycle.

Responsibilities

• Lead end-to-end planning and execution of a healthcare administration and claims platform implementation.
• Ensure continuity of claims processing and member/provider experience throughout implementation.
• Develop and execute enterprise implementation roadmaps, governance structures, risk management frameworks, and transformation strategies.
• Serve as trusted advisor to C-suite executives and executive leadership teams.
• Present program status, risks, mitigation strategies, and transformation outcomes to executive-level audiences.
• Collaborate with cross-functional teams spanning operations, technology, claims administration, enrollment, finance, customer service, compliance, and vendor organizations.
• Author creation of a comprehensive enterprise transformation runbook supporting implementation, cutover, stabilization, and long-term operations.
• Drive program execution across all stages.
• Manage relationships with Aetna, third-party administrators, technology vendors, consulting partners, and internal business units.
• Negotiate priorities, timelines, deliverables, and operational commitments across stakeholder groups.
• Drive accountability across multiple organizations and leadership teams.
• Other duties as assigned.

Qualifications

• 8+ years of progressive leadership experience in relevant healthcare plan domains, including deep experience with Aetna specifically.
• Deep subject matter expertise in healthcare claims systems as well as healthcare payer operations &/or health plan administration.
• Demonstrated success leading large-scale healthcare administration or claims transformation programs.
• Strong knowledge of regulatory and compliance requirements.
• Experience operating within dual-claims or parallel-processing environments preferred.
• Proven ability to communicate and collaborate with executive leadership.
• Proven ability to develop enterprise level runbooks for large scale implementation projects.

Requirements

• The base hourly range for this contract position is $100 - 200 per hour, depending on experience.
• The range displayed reflects the minimum and maximum target for new hires of this position across all U.S. locations.
• Individual pay is determined by work location and additional job-related factors.

Benefits

• LRS is an equal opportunity employer.
• Applicants for employment will receive consideration without unlawful discrimination based on race, color, religion, creed, national origin, sex, age, disability, marital status, gender identity, domestic partner status, sexual orientation, genetic information, citizenship status or protected veteran status.