AI is transforming healthcare, but how can organizations harness its benefits while staying ahead of increasingly sophisticated threats?

In this episode, Shirley Macbeth sits down with Kurt Spear, Vice President of Financial Investigation and Provider Review at Highmark, to explore how AI is improving payment integrity, fraud detection, and operational efficiency. Kurt also shares how his teams are applying AI to identify billing errors, review complex medical records, and uncover emerging fraud schemes.

You will hear why practical use cases matter, how data quality and governance influence AI success, and why human judgment remains essential as healthcare organizations scale AI across critical workflows.

Key takeaways:

• Apply AI to high-impact review workflows where speed and accuracy matter most
• Build AI initiatives around trusted data, governance, and cross-functional input
• Use human expertise to validate AI outputs and stay ahead of emerging fraud risks

Highlights:

(00:00) Introducing Kurt Spear

(01:55) Kurt’s role across fraud investigations and payment integrity

(03:04) The healthcare cost pressures impacting payment integrity

(04:29) Where AI is showing up across the healthcare system

(05:45) Using AI to review records, find errors, and detect fraud

(10:44) How to get started with practical AI use cases

(13:06) Why data quality still matters

(15:20) Bringing teams along in AI adoption

(19:12) Why human judgment is critical to AI decisions

(21:00) Staying ahead of AI-enabled fraud

(22:51) Why AI is now a business imperative

Resources:

Kurt's LinkedIn: https://www.linkedin.com/in/kurt-spear-cfe-cissp-8654842a/ 

Highmark website: https://www.highmark.com/

Highmark LinkedIn: https://www.linkedin.com/company/highmark/

Shirley's LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

In this episode, Shirley Macbeth sits down with Carolynn Smith, Head of US Service at  Prudential, to discuss how AI is reshaping the way Prudential’s service organization delivers outcomes for employees and customers. Carolynn shares insights into how her team is embedding AI within their workflows, leveraging it to improve both employee and customer experiences.

You will hear about the key role frontline employees play in AI adoption, how AI is integrated into service journeys, and the importance of measuring AI outcomes for scaling. Carolynn also reveals how the U.S. Service organization is managing change and driving value by continuously evolving their AI models.

Key takeaways:

• Engage frontline employees in the AI adoption process for greater success
• Use AI to improve operational outcomes while enhancing employee and customer experiences
• Measure what matters to scale AI transformation responsibly

Highlights:
00:00) Introducing Carolynn Smith

(01:00) Why frontline employees are key to AI adoption at Prudential

(02:15) Embedding AI into existing service journeys for better outcomes

(04:00) Overcoming the natural resistance to AI 

(06:00) Creating transparency and aligning expectations for successful AI implementation

(08:30) How recognizing and rewarding early AI adopters drives adoption

(10:00) Measuring success with new KPIs to ensure AI effectiveness

(12:15) The role of responsible AI in Prudential’s service transformation

(14:00) Enhancing empathy and customer service with AI

(16:30) From AI pilots to scaling across the organization

(18:00) Looking ahead: How Prudential is rethinking workflows with AI

Resources:

Carolynn’s LinkedIn: https://www.linkedin.com/in/carolynn-smith-2936b921a/ 

Prudential’s website: https://www.prudential.com/ 

Prudential’s LinkedIn: https://www.linkedin.com/company/prudential-financial/ 

Shirley’s LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

Why do AI programs stall before they scale?

In this episode, Shirley Macbeth sits down with Tim Rafton, Executive General Manager at IAG, to break down how AI is changing the pace of transformation in insurance. With decades of legacy systems and complex processes, Tim shares how his team is finding faster paths to value without waiting for a full platform overhaul.

You will hear how AI handles unstructured data, where to start for early wins, and what it takes to move from experimentation to real workflow impact.

Key takeaways:

• Start with real workflow pain points to drive early AI adoption
• Use AI to unlock value from unstructured data without waiting for full transformation
• Reimagine processes before applying automation or autonomous agents

Highlights:
(00:00) Introducing Tim Rafton

(01:51) The real challenge of AI adoption in legacy industries

(03:31) Where to start with AI inside your organization

(05:00) Turning scattered documents into an AI-powered knowledge system

(06:16) Why fixing the process comes before applying AI

(07:30) Introducing autonomous agents into claims workflows

(10:30) Using AI to structure unstructured data and improve decisions

(12:22) Smarter triage and routing for better customer outcomes

(13:15) Getting executive alignment for AI transformation

(14:00) Why aiming for 100 percent automation changes everything

(15:30) Moving from slow releases to rapid AI iteration

(17:30) Driving adoption by solving real employee problems

Resources:

Tim’s LinkedIn: https://www.linkedin.com/in/timothy-rafton-62927749/?originalSubdomain=au

IAG website: https://www.iag.com.au/

IAG LinkedIn: https://www.linkedin.com/company/iag/

Shirley’s LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

Agentic AI is more powerful than ever. How can organizations keep up with the latest developments to unlock the real potential of AI today? 

In this episode of Make It Real, Shirley Macbeth talks to Samrah Khan, Head of North America Solution Services Partnerships at Google, about the rise of agentic AI. Samrah discusses the significance of the newest shifts in AI technology and how it is improving workflows in industries such as finance and healthcare. She unpacks the pivot to the “human on the loop”, what AI agents need to run efficiently in an organization’s system, and why AI adoption doesn’t just mean a shift in tech but in company culture.

Key takeaways:

• The new role of humans in AI-powered systems
• Why data health is the key to successful AI adoption
• How organizations can help employees overcome AI apprehension

Highlights:
(00:00) Introducing Samrah Khan
(04:50) The latest developments in agentic AI
(06:18) From “human in the loop” to “human on the loop”
(10:57) The hurdle keeping organizations from successfully adopting AI
(13:54) How agentic AI is making an impact in financial services

(16:52) The impact of AI on healthcare CX

(21:08) Why change management is a crucial part of AI adoption

Resources:

Samrah’s LinkedIn: https://www.linkedin.com/in/samrahk/

Google LinkedIn: https://www.linkedin.com/company/google/

Shirley’s LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

A conservative mindset may be keeping an organization from fully realizing the benefits of AI. With clear goals and alignment, businesses can take the first step towards embedding AI in the workflow.

In this episode of Make It Real, Shirley Macbeth chats with David Anderson, Sr. Director for Operations & Vendor Management at CNO, to talk about making the shift from AI apprehension to adoption. David shares the journey of integrating AI into CNO’s customer service operations and what had to happen internally to unlock the benefits of automation. He breaks down the importance of change management and well-defined human roles as an organization learns to embrace AI.

Key takeaways:

• How AI can improve the customer experience
• The role of the end user in shifting to automated processes
• How to push for change management and avoid change fatigue

Highlights:
(00:00) Introducing David Anderson
(02:36) The benefits of bringing AI into complex systems
(03:28) An opportunity to organize unstructured data with AI
(06:42) Aligning on objectives and goals for AI to get leadership buy-in
(09:07) How AI can be used to improve customer experience
(10:34) Quantifying the results of AI adoption

(11:34) How AI allows human agents to focus on customer concerns

(13:41) Change management goes hand in hand with AI adoption

(17:59) Continued growth and increased capacity with AI

Resources:

David’s LinkedIn: https://www.linkedin.com/in/d2anderson/ 

CNO website: https://www.cnoinc.com/ 

CNO LinkedIn: https://www.linkedin.com/company/cno-financial-group/ 

Shirley’s LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

Many organizations are still struggling to bridge the gap between the promise of AI and its reality. So, how can leadership make AI work for them?

In this episode of Make It Real, Shirley Macbeth sits down with Rohit Kapoor, CEO and Chairman at EXL, to discuss AI adoption at the enterprise level. Rohit breaks down what businesses are getting wrong about deploying AI, the impact of AI on workflows, and real stories of how AI has transformed the way companies in complex industries work. He shares advice on picking the right cases for the use of AI, keeping human workers involved in AI adoption, and innovating with speed.

Key takeaways:

• Why organizations aren’t seeing ROI from the use of AI
• The importance of data health in making your org AI-ready
• How AI improves customer experience

Highlights:
(00:00) Introducing Rohit Kapoor
(02:10) Why ROI in AI is still elusive for many businesses
(05:44) Finding the right use cases for AI
(07:32) The key role of data health in AI implementation
(10:31) AI success stories in insurance and utilities
(13:48) How AI helps businesses serve customers better

(15:22) Why humans still matter in an AI-powered org

(18:09) Lessons from EXL’s AI journey

(20:36) Innovating with speed

Resources:

Rohit’s LinkedIn: https://www.linkedin.com/in/rohitkapoorexl/

EXL website: https://www.exlservice.com/

Shirley’s LinkedIn: https://www.linkedin.com/in/shirleymacbeth/

How is AI changing the way your organization works?

EXL brings you Make It Real, a podcast where you’ll hear from leaders with a real, actionable approach to data and AI.

Hosted by Shirley Macbeth, Chief Marketing Officer at EXL, each episode features real stories and real results from organizations embedding AI into their workflows to drive measurable impact. From data modernization to innovative applications of AI, this show explores how today’s leaders are moving from proof of concept to performance.

Stop talking about the promise of AI and start making it real. Subscribe for new episodes every two weeks.