Overview
The healthcare payer landscape is undergoing rapid transformation, driven by demanding consumer expectations, rising operational costs, evolving regulations and the accelerating impact of next-generation technologies. True transformation requires more than just digital tools; it demands intelligent systems that intuitively understand and adapt to the complexities of healthcare payer operations.
At the Innovation Summit 2025, we’re highlighting groundbreaking insights that are poised to transform and build a future resilient healthcare payer organization. Our AI-powered solutions are designed to tackle complex, high-impact processes with minimal human oversight, bringing intelligent autonomy to every layer of the healthcare payer operation while reducing administrative burden, boosting compliance and enhancing consumer experiences.
By combining deep healthcare expertise, process mastery and our proprietary platform AI Force, we are helping healthcare payers modernize their legacy systems, streamline enrollment to claims and care management and achieve experiential, agile and data-driven outcomes while upholding ethical and Responsible AI standards.
Join us at our booth to explore how we can partner and co-create the future of healthcare payers through business-centric AI solutions that empower, insights that inspire and outcomes that endure.
Speaker Session
The future of AI in healthcare: Scaling with Agentic AI
Companies that manage health plans may be tempted to move from the status quo to full-scale AI adoption to enhance operational resilience, overcome talent gaps and improve member-centric care delivery. Though the hopes are high, the challenges lie in effectively integrating AI across their business and IT functions.
HCLTech is enabling this shift with a purpose-built, AI-first approach. Utilizing GenAI and Agentic AI, we assist healthcare payers in adopting a culture of pervasive innovation so they can navigate the AI journey responsibly and sustainably.
Our AI-powered solutions integrate seamlessly across software engineering, business and IT operations lifecycle, enabling a multitude of use cases to boost velocity, efficiency and productivity gains.
Our AI collaboration with healthcare payers aims to achieve intelligent, self-sufficient business processes and drive transformative impact through faster, scalable and more agile ways with minimal human intervention.
Associate Vice President, Head Payer Practice and Solutions
HCLTech
Focus Areas
Energizing the core
Transform legacy systems into agile, AI-powered ecosystems that accelerate innovation, reduce operational costs and enable rapid scalability.
Impact:
Empower healthcare organization with speed, flexibility and resilience to adapt and thrive in a dynamic, competitive market.
Integrated digital operating model
Unify operations, application development and infrastructure under a single, scalable model that eliminates complexity, boosts productivity and ensures cost efficiency.
Impact:
Deliver measurable business outcomes with improved agility and reduced multi-vendor friction.
Scaling AI
Enable healthcare payer to embed GenAI across operation, improving efficiency, unlocking new revenue streams and fueling continuous innovation throughout the value chain.
Impact:
Achieve faster go-to-market, optimized workflows and higher member satisfaction with AI-first strategies.
Data estate transformation
Transform your data ecosystems with cloud-native, AI-integrated platforms to power real-time insights, smarter decisions and scalable operations.
Impact:
Drive enterprise agility, operational efficiency and predictive intelligence in the evolving digital health economy.
Our Solutions
- Energizing the core
- Integrated digital operating model
- Data estate transformation
- Scaling AI
Scaling AI
Smart Prior Authorization – Agentic AI
AI Force
Automate the prior authorization process from intake to tracking using an Agentic AI ecosystem that simplifies compliance and reduces administrative burdens.
Impact:
Accelerate care accessibility, improve turnaround times and enhance member and provider satisfaction through intelligent automation.
Star Ratings Assist – A GenAI-Powered Health Plan Solution
Leverage Agentic AI to centralize, analyze and predict compliance data, automating administrative workflows to optimize STARS and HEDIS ratings.
Impact:
Improve clinical outcomes, ensure regulatory compliance and boost quality scores while enhancing engagement for members and providers.
Data estate transformation
Healthcare data aggregation, transformation and analytics
Build a unified data ecosystem powered by cloud, AI and advanced analytics to create 360° member and provider personas and anticipate demand patterns. Automate healthcare data management with standards-based architecture for future-ready operations.
Impact:
Enable real-time insights, proactive decision-making and predictive intelligence to drive agility, operational efficiency and improved patient outcomes.
AI-powered smart reporting for health plans
Harness GenAI to automate data extraction, validation and interpretation for complex health plan reporting. Empower teams with NLP-based, conversational analytics for instant insights and advanced reporting.
Impact:
Accelerate decision-making, enhance compliance and reduce manual reporting overhead, driving better business outcomes and operational transparency.
Energizing the core
Total Experience – The future of healthcare payer engagement
Deliver personalized, omnichannel experiences across portals, apps and conversational interfaces using AI-driven content management and engagement strategies.
Impact:
Boost member satisfaction, improve retention and strengthen loyalty by creating a seamless, personalized healthcare journey.
Provider Lifecycle Management
Digitally transform provider onboarding and performance management with AI-led automation and compliant workflows to reduce administrative complexity and improve provider collaboration.
Impact:
Accelerate provider onboarding, ensure regulatory compliance and enhance provider satisfaction for a stronger network and better patient care.
Integrated digital operating model
Health plan's unified digital enterprise
Adopt an AI-powered, fully integrated solution and service factory model to run, grow and scale health plan operations at speed.
Impact:
Achieve operational excellence, agility and future-ready consumer personalization to improve engagement and deliver superior member experiences.
Integrated operation solution
Empower your workforce with a next-gen AI-powered collaboration platform that automates tasks, streamlines workflows and enables real-time decision-making across healthcare operations.
Impact:
Reduce operational costs, improve service quality and accelerate response times while enabling seamless collaboration and a digital-first culture.
Analyst Recognitions
HCLTech rated as a Leader in ISG Provider Lens™ - Healthcare Digital Services, U.S.
Learn moreHCL Technologies rated as a Star Performer & Leader in Everest Group Healthcare Payer Digital Services Peak Matrix® Assessment
Learn more
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