Tawfiq Bajjali Of Lyric: How AI Is Disrupting Our Industry, and What We Can Do About It

An Interview With Cynthia Corsetti

Expand the architecture established above to proliferate valuable data across other functions, enriching AI utility over time. Our platform blends payment integrity insights with predictors of network provider abrasion, digital care viability, optimal sites of care and ideal referral patterns.

Artificial Intelligence is no longer the future; it is the present. It’s reshaping landscapes, altering industries, and transforming the way we live and work. With its rapid advancement, AI is causing disruption — for better or worse — in every field imaginable. While it promises efficiency and growth, it also brings challenges and uncertainties that professionals and businesses must navigate. What can one do to pivot if AI is disrupting their industry? As part of this series, we had the pleasure of interviewing Tawfiq Bajjali.

Tawfiq Bajjali, Lyric’s General Manager of Platform Solutions, is at the forefront of digital transformation in healthcare with over two decades of leadership across diverse sectors, including Fortune 500 companies and startups. His pioneering work in developing digital platforms and solutions, combined with an exceptional track record of managing very large technology portfolios, underscores his profound impact on the industry.

Before his tenure at Lyric, Tawfiq was instrumental in shaping the healthcare payer segment at AWS, driving data, analytics, and interoperability solutions at Elevance Health, and leading technology application and analytics teams at Optum. His visionary approach and dedication to digital excellence continue to catalyze Lyric’s mission in revolutionizing healthcare solutions, making healthcare experiences more intuitive, efficient, and accessible for all stakeholders. Tawfiq Bajjali’s leadership not only propels Lyric forward but also sets new benchmarks in the integration of technology and healthcare.

Thank you so much for joining us in this interview series. Before we dive into our discussion our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

I started my career as a software engineer. A key career milestone for me was in the summer of 2008, when I became fascinated with how personalized apps could engage users through data and analytics. I worked on the team that launched mobile banking for Visa, incorporating data and analytics for features like locating ATMs and displaying retailer offers.

Shortly after, when the Affordable Care Act was introduced, I decided to transition into healthcare to leverage data and analytics to tackle impactful challenges. I took a role at Ingenix, later Optum Insights, measuring provider cost and quality. I then worked at a mobile app modernization platform startup before returning to Optum, to work on implementing state-based insurance exchanges and fixing the healthcare.gov website.

After that, I joined Anthem, now Elevance Health, for 7 years. I worked on building a modern data and AI/ML foundation generating insights across the organization — later becoming a core component of Carelon’s Digital Platform. I then led teams building HealthOS, our provider connectivity solution for sharing insights to enable value-based care.

Next, I led industry solutions, strategy, and business development for healthcare payers at Amazon Web Services. We collaborated extensively with partners leveraging our platform to accelerate payers’ digital transformation and AI adoption globally.

Now at Lyric, we’re evolving our industry-leading editing software into a platform introducing new payment accuracy and value capabilities to reduce system costs and enable payor-provider collaboration. I’m grateful for everyone I’ve worked with on this journey and am excited for the future innovations my Lyric colleagues and I are driving.

What do you think makes your company stand out? Can you share a story?

Lyric has an unparalleled 30+ year legacy with our flagship ClaimsXten product — trusted by over 100 customers including 9 of the top 10 US healthcare payers. Behind this product is an exceptional group that helped establish our company as a leader in claims editing.

Since separating from Change Healthcare, we have invested heavily in a world-class team to evolve Lyric into a platform company. Our new hires bring invaluable experience building secure, cloud-based platforms, developing AI models, deeply understanding customer needs, and marketing solutions. Most importantly, this combined team of legacy employees and new talent collaborate exceptionally well together around a shared vision of where the industry is headed.

Our legacy in this market combined with fresh perspectives lays the foundation for Lyric to deliver continued innovation. We have leveraged our tenure and trust with customers to identify emerging needs, while assembling experts to create solutions leveraging modern architectures. This fusion of institutional knowledge and expanded capabilities makes Lyric stand out as we help customers navigate the opportunities ahead.

You are a successful business leader. Which three-character traits do you think were most instrumental to your success? Can you please share a story or example for each?

I am a builder at heart. Understanding systems in their entirety, from granular details to overarching vision, helps me problem-solve and incrementally advance solutions. By diving deep alongside teams, I gain insight enabling thoughtful enhancements rooted in past decisions and data-driven tradeoffs. This collaborative exercise fosters collective ownership as we advance the work.

I also consider myself customer-obsessed, focusing squarely on delivering maximum value and service quality to clients rather than monitoring competitors. Our model relies on frontline teams deeply understanding customer goals, then voicing needs back into the organization to shape highly personalized, high-performing solutions. Engineering and services teams then embrace the challenge to architect innovative yet pragmatic offerings.

Additionally, I believe I am fairly resilient which is imperative for this complex mission of digitally transforming healthcare. Navigating disjointed systems with divergent priorities means constantly educating, adapting, and rallying support while persevering through hurdles. Still, staying optimistic and capitalizing on forward progress keeps me progressing uphill. Regardless of company size, transformative change is a marathon requiring patient persistence.

Let’s now move to the main point of our discussion about AI. Can you explain how AI is disrupting your industry? Is this disruption hurting or helping your bottom line?

The healthcare payer industry is amid a digital transformation, building a foundation to embrace AI’s potential. Leading organizations have invested heavily in modernizing backend systems, data architecture, infrastructure, and member-facing apps over the past decade. AI can now accelerate this work to improve operations, experiences, access, costs, and quality.

There is burgeoning adoption of digital health apps and virtual care, fueled by increasing consumer demand and payer promotion. For instance, Elevance Health is providing smart devices to members while seeing exponential virtual visit growth. Amazon’s expanding digital pharmacy and virtual clinic offerings also showcase the traction.

Interoperability mandates have also unlocked valuable data sharing between payers and providers, powering AI. Health tech suppliers facilitate this exchange via API-based solutions that ingest, manage, and analyze the data. Cloud platforms provide enabling services for storage, analytics, and app development.

Our digital platform consolidates compatible partner solutions so clients can adopt AI capabilities without intensive integration. We’ve transitioned our flagship editing software into a modular app within the platform. Soon we’ll offer integrated payment integrity and reporting apps, using AI techniques to simplify insights. We’re also working on cost and care optimization models to recommend clinical actions and streamline workflows.

By tapping exponential data growth and cloud-hosted AI, our platform can rapidly advance customers’ transformations. Healthy competition around enhancing experiences and value will raise the bar industry-wide. But success ultimately hinges on an agile, collaborative, and innovative culture open to emerging technologies.

Which specific AI technology has had the most significant impact on your industry?

Generative AI: for bringing the capability to generate content. For example, we can now summarize complex healthcare decisions and information — streamlining processes requiring heavy amounts of preparation, or review. In addition, to better inform decisions for healthcare stakeholders, including patients.

Can you share a pivotal moment when you recognized the profound impact AI would have on your sector?

We were working with a customer on enhancing their contact center system and started to play around with fine-tuned foundational models to generate a summary about a member’s history, and the results we got were better than expected. It allowed the customer to reduce both call prep time and time spent after the call by 50%.

How are you preparing your workforce for the integration of AI, and what skills do you believe will be most valuable in an AI-enhanced future?

We are cultivating four complementary skillsets to prepare our workforce for AI integration:

  1. First, deep domain experts who comprehend payer workflows, data flows, business rules and health economics. They will ensure AI aligns with and enhances human-driven processes.
  2. Second, specialized talent to navigate regulatory, ethical and data privacy considerations, ensuring our AI is deployed responsibly.
  3. Third, data scientists who are capable of wrangling, analyzing, and applying vast data volumes to construct and refine AI models.
  4. Finally, cloud engineering acumen for seamless cross-platform integration between legacy and modern systems that still delivers on scalability, security, and efficiency.

Above all, our teams embrace radical collaboration to fuse these perspectives. Alongside technical prowess, human-centered skills like critical thinking and communication confer organizational readiness to extract AI’s benefits.

What are the biggest challenges in upskilling your workforce for an AI-centric future?

Our greatest AI upskilling challenge is simply meeting boundless employee enthusiasm. Through expanded course access, cloud-led programs, hands-on labs, and experienced mentors, we strive to elevate both technical and collaborative intelligence. Our specialists also champion literacy for business analysts, compliance, and clinical coders to spur responsible innovation.

This hunger for continuous advancement means recalibrating frameworks to keep pace. But eager learners undaunted by change provide the ultimate catalyst for transformation. By channeling this institutional inspiration, rather than resisting inevitability, we gain an invaluable competitive edge. Our people ultimately fuel the fluidity enabling customer-centered breakthroughs.

What ethical considerations does AI introduce into your industry, and how are you tackling these concerns?

As an AI-first company operating as a leader in healthcare payment integrity, Lyric endorses responsible AI practices and benchmarks that improve AI trustworthiness and safety dimensions — for us and our clients. We’re committed to balancing the transformational application and impact of AI with a roadmap to bolster accuracy, ethics, and adherence to nationally accepted standards.

What are your “Five Things You Need To Do, If AI Is Disrupting Your Industry”?

  1. Assemble diverse teams covering ethics, data, engineering, domain expertise and portfolio strategy. Pilot a targeted AI model with a well-defined goal and data needs.
  2. Identify AI opportunities with a focus on a single business function that you want to streamline, using pre-built AI/ML models that you can license and leverage existing data integrations in your organization. Architect for iterative improvement via parallel model evaluation and automated pipeline integration. For example, our platform lets customers invoke multiple payment integrity models; and selects top saving recommendations with AI explainability.
  3. Expand the architecture established above to proliferate valuable data across other functions, enriching AI utility over time. Our platform blends payment integrity insights with predictors of network provider abrasion, digital care viability, optimal sites of care and ideal referral patterns.
  4. Re-engineer symbiotic partner relationships by first deeply understanding their AI ambitions and vendors, then incentivizing joint process innovation across technologies. For instance, simplify prior authorization by aligning provider workflows with payer data and intelligence products from shared vendors. Or, collaborate to pilot new innovations like AI for automating authorization approval based on analytics-driven clinical criteria and protocols. Motivate ecosystem change through value-based arrangements sharing risks and rewards. The key is fully grasping partner roadmaps and trusted technology suppliers. This awareness allows orchestrating win-wins by converging objectives, leveraging existing systems, and demonstrating return on investment for surface-level competitors to become collaborators. Breakthrough change requires breaking silos, so map the intersection of needs and possibilities to make the status quo obsolete.
  5. Look beyond the immediate value-chain by collaborating with companies pioneering solutions like GenAI’s platforms leveraging AI for drug discovery. Specifically, models generating cells mimicking individual tissues and organs based on genes and health data to test treatments or introduce mutations simulate disease at the N-of-1 level. This facilitates precision medicine for patients with rare, hitherto untreatable conditions. Pilot bold new care delivery models merging such innovations with other breakthroughs across the healthcare continuum, like AI-generated cell models enabling customized disease diagnosis and treatment plans. By streamlining data sharing and aligned incentives between startups, providers and payers, this ecosystem approach can realize game-changing integrated health interventions to directly benefit members.

What are the most common misconceptions about AI within your industry, and how do you address them?

A few common misconceptions exist around AI in healthcare — namely, that it will be fully autonomous, easily implemented, and replace doctors. In reality, major obstacles like poor data interoperability across disconnected systems still require heavy lifting. All the models constructed will also need ongoing human oversight to ensure responsible, unbiased outputs before being integrated into workflows.

Even innovative apps supporting patients or clinicians are complementary rather than replacements. They may help answer questions or monitor chronic conditions, providing value between visits, but human expertise remains indispensable, especially for complex decision-making. If anything, by alleviating burdens like documentation, AI stands to empower providers to focus more attention on delivering thoughtful care.

The path forward relies on AI augmenting rather than supplanting roles across the care continuum. Realizing this collaborative potential will hinge on transparent AI governance, earnest data system connectivity efforts and clear understanding of remaining human primacy in healing. With prudent expectations set around capabilities versus limitations, healthcare AI can blossom responsibly.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

One of my favorite quotes is from former Secretary of State and US Army General Colin Powell about leadership. He said, “Leadership is about solving problems. The day soldiers stop brining you their problems is the day you have stopped leading them.” This has always been a priority for me when it comes to the teams I lead. Nothing brings me more joy than an evening call years after I left a job from a former colleague wanting to talk through something. I really enjoy that and being able to do the same.

Off-topic, but I’m curious. As someone steering the ship, what thoughts or concerns often keep you awake at night? How do those thoughts influence your daily decision-making process?

I am astonished at the exponential pace of AI advancement. My aim is striking the right balance between leveraging bleeding-edge capabilities and ensuring product stability for customers dependent on our solutions. We want to deliver cutting-edge software that taps into the latest viable innovations, without compromising the reliability and outcomes our users trust us for.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I recently attended a dinner organized to bring awareness to the impact human cause climate change has on all the food that I take for granted. It will impact many things, but sitting at the dinner and eating food that I love that will be in very short supply in as close as 20 years from now really stuck with me. I am not an expert on the specific problems, and if I were to start a movement, it would be to learn more about the problems and participate in solving them.

How can our readers further follow you online?

Our very talented marketing team set up a company blog for us to share thought leadership content. I’ll be documenting our journey and advancements there so please visit our website www.lyric.ai.

Thank you for the time you spent sharing these fantastic insights. We wish you only continued success in your great work!

About the Interviewer: Cynthia Corsetti is an esteemed executive coach with over two decades in corporate leadership and 11 years in executive coaching. Author of the upcoming book, “Dark Drivers,” she guides high-performing professionals and Fortune 500 firms to recognize and manage underlying influences affecting their leadership. Beyond individual coaching, Cynthia offers a 6-month executive transition program and partners with organizations to nurture the next wave of leadership excellence.