Principal AI Product Lead - Healthcare Payment Accuracy & Decision Intelligence

Location : Hyderabad

About Us :

Rialtic and Exponential AI recently merged to create a unified platform spanning the full healthcare claims lifecycle - combining Rialtic's rules-based payment accuracy platform with Exponential AI's Enso platform of prebuilt Decision Agents. Headquartered in Atlanta, the combined company serves leading U.S. health plans and provider systems, with a dedicated R&D center in Hyderabad, India.

Our mission is to help payers and providers make healthcare meaningfully more affordable for American families and employers. We do this by embedding agentic AI systems - intelligent decision agents - directly into claims and clinical workflows to automate reviews, identify payment issues, and support real-time decision-making, while delivering transparent, predictable, and explainable machine decisions in real time.

About the Role :

We're looking for a Principal AI Product Lead to drive product strategy and execution for our unified payment accuracy and decision intelligence platform. You'll own one or more flagship areas across our product suite - spanning claims adjudication, coordination of benefits, claims audit, payment integrity, contract management, and utilization management - and shape how AI Decision Agents are productized, scaled, and adopted by the largest payers and provider systems in the country.

This is a senior individual contributor role with executive visibility. You'll be a critical voice in defining how the combined Rialtic + Exponential AI roadmap evolves post-merger, with the autonomy to set direction and the responsibility to deliver measurable client outcomes.

What You'll Do :

- Own end-to-end product strategy and roadmap for AI-powered offerings across the claim lifecycle, from prepay editing to real-time decision intelligence during and after adjudication.

- Productize and scale Decision Agents on the Enso platform - defining which agents to build, how they compose into client-facing solutions, and how they integrate with Rialtic's editing system and customers' legacy infrastructure.

- Translate complex payer and provider problems - payment integrity leakage, claims rework, prior auth bottlenecks, contract compliance, audit defensibility - into well-scoped, high-ROI AI product opportunities.

- Partner closely with AI and ML engineering, data science, and platform teams to define agent requirements, evaluation criteria, and acceptable accuracy and explainability thresholds for production deployment.

- Engage with health plan executives, provider finance executives, payment integrity leaders, and clinical operations teams to validate problems, co-design solutions, and drive adoption.

- Establish frameworks for responsible and explainable AI in claims and clinical decisioning - bias auditing, human-in-the-loop review, audit trails, and continuous learning from feedback loops.

- Define success metrics that matter to clients : dollars saved, leakage prevented, cycle time reduced, auto-adjudication rates, false positive rates, and provider abrasion.

- Serve as a thought partner to the leadership on portfolio strategy, M&A integration priorities, and category positioning in a rapidly consolidating market.

- Mentor product managers, engineers across the combined organization and help shape product culture during this pivotal post-merger phase.

What You Bring :

- 10-15 years of product management experience, with a substantial portion building enterprise products in the U.S. healthcare payer and/or provider markets.

- Expertise in at least one of : payment integrity, claims editing and adjudication, payment accuracy, utilization management, revenue cycle management, contract management, or healthcare audit.

- Proven track record of shipping AI/ML-powered products at enterprise scale - ideally including agentic AI, decision intelligence, or workflow automation deployed at health plans or large provider systems.

- Direct experience with Decision Agents, agentic AI architectures, or LLM-powered enterprise workflows in healthcare administration.

- Technical literacy to engage substantively with AI/ML and platform engineers on agent architecture, model evaluation, real-time inference at scale, integration with legacy core admin systems, and trade-offs between deterministic rules and learned models.

- Strong fluency in healthcare regulation and compliance : HIPAA, state-level payer regulations, CMS guidance, and emerging AI governance standards relevant to administrative AI.

- Excellent written and verbal communication; you can move fluidly between a payment integrity leader, an AI/ML engineer, and a board deck.

- Bachelor's degree required; advanced degree a plus.

Nice to Have :

- Knowledge of healthcare claims data (837/835, EDI), coding systems (ICD-10, CPT, HCPCS, DRG), payer policies, NCCI edits, and the operational realities of claims processing.

- Prior product role at a payment integrity vendor (e.g., Cotiviti, ClaimsXten/Lyric, EXL, Optum, Zelis) or at a major health plan's payment integrity, SIU, or claims operations team.

- Experience integrating with major core admin platforms (Facets, QNXT, HealthEdge, HealthRules) and provider EHRs (Epic, Oracle Health/Cerner).

- Background leading product through a post-merger integration or platform consolidation.

- Familiarity with FHIR, X12, and modern healthcare interoperability standards.