RISA Labs, Inc.
Payer Strategy Lead Washington, DC
RISA Labs, Inc., Washington, District of Columbia, us, 20022
Overview
RISA is building mission critical healthcare infrastructure using advanced AI, starting with the most complex workflows in oncology. We deliver resilient, autonomous systems that accelerate clinical operations and revenue for providers, specialty pharmacies and health plans. Founders RISA was founded by Kshitij Jaggi and Kumar Shivang, IIT Kanpur alumni with a proven track record from their previous healthcare startup, Urban Health. Their vision is to streamline oncology care through cutting edge technology. Funding RISA Labs is a Series A startup backed by Optum Ventures, Cencora Ventures, Oncology Ventures, General Catalyst, Binny Bansal, z21 Ventures, John Simons and select angels. Role Overview
This is not a traditional partnerships or sales role. As a
Payer Strategy Lead , you will be RISA’s primary interface into payer strategy, operations, and policy execution. You will leverage your existing payer network to establish and deepen strategic relationships while translating regulatory intent into practical, scalable workflows that RISA can power. You’ll operate at the intersection of regulation, technology, and real-world execution-ensuring RISA’s platform aligns with how payers are actually operationalizing CMS mandates, not how they’re written on paper. Key Outcomes & Responsibilities
Payer Relationship Development
— Leverage existing relationships with national and regional payers across Commercial, Medicare Advantage, and Medicaid markets to establish trusted working and leadership-level partnerships. Serve as RISA’s primary point of contact for payer-side strategy, operations, and policy discussions, turning early engagement into long-term, system-level collaboration across organizations managing 100M+ covered lives. Operational Streamlining & Payer Interface Enablement
— Work directly with payer teams to streamline operational touch points where RISA interfaces with payer systems, including: Eligibility verification and benefits (EV-BV) responses; Coverage rules, medical necessity criteria, and exception handling; Policy and guideline updates. Reduce friction, ambiguity, and latency in payer–provider–platform interactions, positioning RISA as a neutral execution layer rather than another vendor. Capability - Requirement Intersection
— Identify and define the intersection between: RISA’s platform capabilities (automation, AI agents, workflow orchestration, traceability) and payer operational needs, compliance requirements, and real-world constraints. Surface opportunities where RISA can replace manual processes, standardize execution, and become essential infrastructure embedded in payer operations. Internal Translation & Influence
— Act as the translator between payer reality and RISA’s internal teams across product, engineering, and go-to-market. Shape product requirements, integration priorities, and positioning based on real payer needs — not assumptions. Influence how RISA presents itself to the market: as execution infrastructure that increases payer capability, not technology they must manage. Ideal Background
Deep experience working with or within payer organizations (health plans, PBMs, Medicare Advantage, Medicaid programs) Strong existing relationships with payer leaders across policy, operations, utilization management, or innovation teams Firsthand understanding of prior authorization, utilization management, EV-BV, and policy rollout challenges Technical fluency in healthcare interoperability standards, including FHIR, X12 transactions, HL7, and CMS Da Vinci implementation guides Comfort operating at the intersection of regulation, operations, and technology Ability to navigate ambiguity and help define a category, not just execute within one Executive presence and ability to translate complex infrastructure into strategic business value Why This Role Matters
CMS mandates have created a market opportunity that didn’t exist 18 months ago. Every payer relationship you build doesn’t just grow revenue - it rewrites how prior authorizations and administrative workflows function for millions of patients waiting for care. You’ll skip the legacy EDI playbook and build modern healthcare infrastructure from first principles. You’ll help define how an entire industry operationalizes its future. And you’ll do it with a team that believes healthcare administration can actually work better.
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RISA is building mission critical healthcare infrastructure using advanced AI, starting with the most complex workflows in oncology. We deliver resilient, autonomous systems that accelerate clinical operations and revenue for providers, specialty pharmacies and health plans. Founders RISA was founded by Kshitij Jaggi and Kumar Shivang, IIT Kanpur alumni with a proven track record from their previous healthcare startup, Urban Health. Their vision is to streamline oncology care through cutting edge technology. Funding RISA Labs is a Series A startup backed by Optum Ventures, Cencora Ventures, Oncology Ventures, General Catalyst, Binny Bansal, z21 Ventures, John Simons and select angels. Role Overview
This is not a traditional partnerships or sales role. As a
Payer Strategy Lead , you will be RISA’s primary interface into payer strategy, operations, and policy execution. You will leverage your existing payer network to establish and deepen strategic relationships while translating regulatory intent into practical, scalable workflows that RISA can power. You’ll operate at the intersection of regulation, technology, and real-world execution-ensuring RISA’s platform aligns with how payers are actually operationalizing CMS mandates, not how they’re written on paper. Key Outcomes & Responsibilities
Payer Relationship Development
— Leverage existing relationships with national and regional payers across Commercial, Medicare Advantage, and Medicaid markets to establish trusted working and leadership-level partnerships. Serve as RISA’s primary point of contact for payer-side strategy, operations, and policy discussions, turning early engagement into long-term, system-level collaboration across organizations managing 100M+ covered lives. Operational Streamlining & Payer Interface Enablement
— Work directly with payer teams to streamline operational touch points where RISA interfaces with payer systems, including: Eligibility verification and benefits (EV-BV) responses; Coverage rules, medical necessity criteria, and exception handling; Policy and guideline updates. Reduce friction, ambiguity, and latency in payer–provider–platform interactions, positioning RISA as a neutral execution layer rather than another vendor. Capability - Requirement Intersection
— Identify and define the intersection between: RISA’s platform capabilities (automation, AI agents, workflow orchestration, traceability) and payer operational needs, compliance requirements, and real-world constraints. Surface opportunities where RISA can replace manual processes, standardize execution, and become essential infrastructure embedded in payer operations. Internal Translation & Influence
— Act as the translator between payer reality and RISA’s internal teams across product, engineering, and go-to-market. Shape product requirements, integration priorities, and positioning based on real payer needs — not assumptions. Influence how RISA presents itself to the market: as execution infrastructure that increases payer capability, not technology they must manage. Ideal Background
Deep experience working with or within payer organizations (health plans, PBMs, Medicare Advantage, Medicaid programs) Strong existing relationships with payer leaders across policy, operations, utilization management, or innovation teams Firsthand understanding of prior authorization, utilization management, EV-BV, and policy rollout challenges Technical fluency in healthcare interoperability standards, including FHIR, X12 transactions, HL7, and CMS Da Vinci implementation guides Comfort operating at the intersection of regulation, operations, and technology Ability to navigate ambiguity and help define a category, not just execute within one Executive presence and ability to translate complex infrastructure into strategic business value Why This Role Matters
CMS mandates have created a market opportunity that didn’t exist 18 months ago. Every payer relationship you build doesn’t just grow revenue - it rewrites how prior authorizations and administrative workflows function for millions of patients waiting for care. You’ll skip the legacy EDI playbook and build modern healthcare infrastructure from first principles. You’ll help define how an entire industry operationalizes its future. And you’ll do it with a team that believes healthcare administration can actually work better.
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