AI Solution Consultant

Job Summary:

The AI Solution Consultant serves as the primary "Face of AI" for CareSource business units, acting as a strategic bridge between clinical/operational domains and the technical AI Platform team. This role is responsible for driving the enterprise-wide intake and triage process, stratifying opportunities into Green (Self-Service), Yellow (Citizen Dev), and Red (Pro-Code) tiers. The Consultant partners directly with business executives to define high-value use cases, modeling ROI and ensuring alignment with the organization's mission to improve member experience and health outcomes.

Essential Functions:

• Lead the common intake process for all AI initiatives, utilizing the "Traffic Light" framework to stratify requests into green, yellow, or red risk tiers.
• Conduct Art of the Possible workshops and discovery sessions with business leaders (Clinical, Claims, Ops) to identify high-ROI opportunities for agentic and generative AI.
• Develop robust business cases and value assessments, including projected efficiency gains, cost reductions, and quality improvements, for presentation to the AI Steering Committee (AISC).
• Act as a trusted advisor to citizen developers in the yellow layer, guiding them toward approved low-code tools (UiPath, Databricks) and ensuring architectural alignment.
• Partner with the AIEC to define functional requirements for complex red layer clinical agents, ensuring clarity on human-in-the-loop needs.
• Serve as the primary liaison between business product owners and the AI Platform Engineering team, translating business needs into technical user stories.
• Evaluate AI usage within business units and migrate unauthorized tools into the managed green or yellow layer governance structures.
• Monitor and report on the value realization of deployed solutions, tracking actual vs. projected ROI and operational throughput uplift.
• Assist in the creation of domain-specific prompt libraries to accelerate adoption of Microsoft 365 Copilot within specific departments (e.g., HR, Finance).
• Facilitate user acceptance testing (UAT) coordination between the business stakeholders and the IT development teams for red layer builds.
• Provide consultative support for yellow layer exceptions, helping power users navigate the IT review and approval gates.
• Maintain a deep understanding of the evolving AI landscape (Agentic workflows, RAG) to proactively suggest innovation opportunities to business partners.
• Perform any other job related duties as requested.

Education and Experience:

• Bachelor's degree in Computer Science, Business, or a related field required
• Master's degree in Computer Science, Business, or a related field preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Eight (8) years of experience in IT Consulting, Solution Architecture, or Technical Product Management required
• Experience leading digital transformation initiatives, defining ROI models, and shaping business strategy required

Competencies, Knowledge and Skills:

• Strategic consulting skills, with the ability to lead Art of the Possible workshops and influence senior business leaders
• Deep Healthcare Payer industry knowledge (Utilization Management, Claims, Prior Auth)
• Proficiency in Generative AI concepts, capable of explaining the difference between Deterministic (Rules-based) and Probabilistic (AI) systems to non-tech audiences
• Strong business case development skills, able to model financial impacts (OpEx savings, productivity gains)
• Ability to navigate "Traffic Light" governance, guiding business teams on whether a request is Green (Self-service), Yellow (Low-code), or Red (Pro-code)
• Familiar with Low-Code platforms (UiPath, Power Platform) to advise on "Yellow Layer" citizen development opportunities

Licensure and Certification:

• TOGAF or Zachman Framework certification preferred
• SAFe Agilist or similar Agile Architecture certification preferred

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required

Compensation Range:

$113,000.00 - $197,700.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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