Rishiitaa Kulkarni

Lead large-scale health claims and operations portfolio, ensuring regulatory compliance, cost efficiency, and service excellence across high-volume processes Spearhead transformation initiatives aimed at digitization, automation, and process redesign to reduce TAT and enhance customer experience Collaborate with cross-functional teams including IT, product, actuarial, and customer service to drive operational scalability and quality outcomes Drive strategic planning, performance benchmarking, and governance frameworks to support business growth and efficiency goals Mentor and develop high-performing teams with a focus on accountability, agility, and continuous learning Serve as a key escalation and decision-making point for critical cases, regulatory audits, and cross-border process transitions Champion people-first leadership with a focus on trust, communication, and empathy — embedding a human approach to operational rigor Represent health claims function in leadership forums, audits, regulatory reviews, and CX councils Key Achievements: ✔️ Successfully ltech-led transformation for claims, customer service ✔️ Recognized in the Top 10% – 1000 Women Leaders program for leadership excellence ✔️ Introduced dashboards/analytics to enable proactive decision-making and SLA governance ✔️ Drove a major shift from reactive to preventive claims handling through risk identification & process control ✔️ Piloted key automation projects in pre-auth and post-discharge workflows

Capstone Project- Healthcare, Tableau, Machine Learning, Predictive Modeling, Data Mining, Advanced Statistics, Time series Forecasting, Market & Retail Analysis, Financial Risk Analysis, Python for data science, Statistical Methods for Decision making.