Cloud and Health AI FinOps and Technology Value Optimization
Guidehouse · Remote · United States · 20d ago
Job Family:
Technology Consulting
Travel Required:
Clearance Required:
We are seeking a senior leader to build and lead our Cloud and AI FinOps and Technology Value Optimization capability for healthcare provider clients. This is a portfolio role, not a single-engagement role. The successful candidate will carry concurrent delivery accountability across multiple health system clients, own the commercial performance of that portfolio, shape the methodologies and assets that make the capability repeatable, and serve as the practice's most credible voice with CFOs, CIOs, and Chief Data and AI Officers on what cloud and AI actually cost and what value they actually return.
The immediate anchor assignment is a large academic medical center's Azure migration, where this leader will own a two-workstream program spanning cloud FinOps enablement and organizational change management. That engagement is the entry point to a broader agenda: as health systems move workloads and stand up AI platforms, they are discovering that consumption-based economics, fragmented application portfolios, and immature governance compound each other. This leader will connect those problems — FinOps discipline, application and AI workload rationalization, cloud operating model design, and the change management required to make any of it stick — into a coherent point of view and a growing book of work.
This role suits someone who is equally comfortable in front of a finance committee defending a commitment strategy, in a working session with cloud engineers debating tagging enforcement, and in a practice leadership meeting arguing for where to invest next. It carries real autonomy, real revenue accountability, and a clear path to Partner-track responsibility.
What You Will Do:
Client and Portfolio Leadership
- Hold delivery and commercial accountability for a portfolio of concurrent cloud and AI FinOps, rationalization, and technology value optimization engagements, including scope, quality, margin, staffing, risk posture, and client satisfaction across all of them.
- Serve as the senior client-facing voice with CFOs, CIOs, Chief Data and AI Officers, and their governance committees — framing tradeoffs, defending recommendations under scrutiny, and converting analysis into decisions leadership is willing to fund and act on.
- Set the standard for executive deliverables across the portfolio, personally shaping the narrative, structure, and defensibility of board- and committee-level materials rather than reviewing them at the margin.
- Manage the balance between advisory posture and hands-on execution, deploying the team into direct build work where client capacity is constrained without allowing the engagement to drift into unpriced staff augmentation.
Cloud and AI FinOps
- Lead establishment of durable FinOps capabilities for cloud and AI workloads, spanning consumption baselining, cost allocation and unit economics, showback and chargeback design, forecasting, anomaly management, and value realization tracking.
- Advise clients on enterprise agreement and commitment strategy, including commitment sizing and right-sizing, reservation and savings plan portfolios, consumption trajectory risk, and the financial exposure created by aggressive multi-year commitments.
- Bring a defensible point of view on AI and analytics workload economics — GPU and inference cost behavior, consumption-based data platform pricing, model and token-level attribution, and the shared-service allocation problems that make AI spend uniquely difficult to govern.
- Direct design of cloud operating model components that sustain FinOps beyond the engagement: Cloud Center of Excellence structures, intake and provisioning workflows, tagging taxonomies and enforcement automation, decision rights, policy guardrails, and recurring cost review routines.
- Oversee automation and reporting build-out across native cloud cost management tooling, data platform usage telemetry, and enterprise BI, ensuring clients inherit working instrumentation rather than a static assessment.
Cloud and AI Rationalization and Value Optimization
- Lead application and workload rationalization engagements, including portfolio inventory and segmentation, disposition analysis, cloud candidacy and workload placement criteria, migration wave sequencing, and the business cases that justify retire, consolidate, replatform, or modernize decisions.
- Extend rationalization discipline to the emerging AI estate — redundant models, pilots, copilots, and point solutions — and help clients distinguish AI investments that are compounding value from those that are accumulating cost and risk.
- Connect rationalization findings to run-rate reduction, contract and licensing optimization, technical debt retirement, and reinvestment capacity, quantified in terms finance leadership will stand behind.
- Partner with enterprise architecture, infrastructure, security, and data leaders to ensure disposition and placement recommendations account for interoperability, regulatory, data retention, and risk constraints specific to healthcare.
Change Enablement and Adoption
- Hold accountability for the organizational change management workstreams attached to cloud and AI programs, directing change strategy, stakeholder and impact assessment, communications, change networks, role-based training, and adoption measurement through dedicated change leads.
- Ensure the operating model and cost governance work is matched by genuine organizational adoption, treating readiness and behavior change as delivery outcomes rather than supporting activities.
Practice Building and Growth
- Originate and close follow-on and net-new work across the portfolio, including scoping, pricing, proposal development, and oral presentations, with accountability for an annual sales or expansion target.
- Build the reusable methodologies, accelerators, maturity models, benchmarks, and pricing constructs that turn repeated engagement work into a scalable practice capability.
- Represent the firm externally through thought leadership, conference participation, client roundtables, and hyperscaler and platform partner relationships that generate pipeline.
- Recruit, develop, and performance-manage consultants through senior manager level across FinOps, cloud engineering, application portfolio, and change management skill sets, and serve as career advisor to a group of professionals.
What You Will Need:
- Minimum of SEVEN (7)+ years of overall work experience.
- Bachelors degree from an accredited university.
- Experience in technology consulting, cloud and technology financial management, or technology transformation.
- Experience in engagement leadership level with accountability for delivery outcomes and commercial performance.
- Demonstrated ownership of a portfolio of concurrent engagements — not sequential single-project leadership — including staffing across teams, margin management, and executive relationship ownership at multiple accounts simultaneously.
- Deep command of cloud economics on at least one major hyperscaler, with Microsoft Azure strongly preferred, including enterprise agreements and commitment constructs, native cost management tooling, reservations and savings plans, tagging and policy enforcement, and allocation across shared and dedicated services.
- Track record establishing FinOps capabilities aligned to recognized frameworks across the inform, optimize, and operate domains, with evidence of capabilities that persisted after the consulting team departed.
- Substantive experience in application portfolio rationalization, workload placement, or technology cost reduction, including disposition frameworks, business case development, and executive decision governance.
- Working fluency in AI and data platform economics, including consumption-based analytics platforms, GPU and inference cost drivers, and the attribution challenges created by shared AI and analytics services.
- Demonstrated accountability for organizational change management as an integrated workstream, including change strategy, adoption measurement, and executive-level stakeholder management.
- Proven ability to sell — origination, scoping, pricing, proposal leadership, and closing — with a credible record of revenue generated or expanded.
- Executive presence sufficient to hold a room of C-suite healthcare leaders, including the judgment to deliver unwelcome findings about cost exposure, failed governance, or unrealistic business cases without losing the relationship.
What Would Be Nice To Have:
- Experience serving academic medical centers, integrated delivery networks, and other healthcare provider organizations, including fluency with service line economics, fund and grant accounting, research computing, and public institution procurement and governance constraints.
- Familiarity with the healthcare platforms that drive the majority of cloud and AI consumption, including Epic and Oracle Health ecosystems, enterprise data platforms, imaging, and clinical and research analytics workloads.
- FinOps Certified Professional credentials, Prosci or equivalent change management certification, and Azure architecture certifications; familiarity with the Cloud Adoption Framework and Well-Architected Framework.
- Experience building a consulting capability or offering from an early stage to a repeatable, multi-client business, including methodology development, pricing strategy, and team build-out.
- Established relationships with hyperscaler and platform partner field organizations that translate into co-sell pipeline.
- Experience with adjacent scopes that extend cloud FinOps engagements, including multi-cloud and SaaS spend management, sustainability and carbon reporting, and enterprise technology business management.
- Advanced degree such as an MBA, MHA, or master's in information systems, and a record of published thought leadership or conference speaking in cloud economics, AI governance, or healthcare technology strategy.
- US Citizenship is contractually required.
About the Role:
Healthcare organizations are committing to cloud and AI at a pace that has outrun their ability to govern the spend or prove the return. Commitments are signed before consumption is understood, workloads migrate before portfolios are rationalized, and AI pilots multiply faster than anyone can measure what they cost. The leader in this role will be the person clients call when they need that situation made legible and then fixed — and will build the team, methods, and market position that let the firm answer that call at scale. Success looks like clients who can defend every dollar of cloud and AI spend, portfolios that are meaningfully smaller and better governed, and a practice capability that outlasts any single engagement.
The annual salary range for this position is $149,000.00-$248,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Student Loan PayDown
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Mobility Stipend
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
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