Vacancy expired!
- Lead the creation and evolution of the automation architecture.
- Lead and facilitate the creation and implementation of automation governance practices and other automation tools.
- Leads research, analysis, and translation of business drivers into business, information, and technical requirements that can transform a domain.
- Identifies, evaluates, and participates in innovation proof of concepts (POCs). Advises on architectural impact and POC considerations.
- Defines overall direction and creates business and enterprise architectures to effectively support business strategy through the delivery of models, frameworks, and other artifacts that guide the organization and effectively support the corporate business strategy.
- Documents contribution to business and technical architectures, strategies, and initiatives.
- Documents proposals addressing current and future state architectural changes that have a business and technical impact.
- Maintain an ongoing partnership with customer's business to apply in-depth knowledge of the business operations, strategies, priorities, and information requirements to establish a technical direction with an enterprise view
- Provide strategic guidance and research across all health plan domains such as Products, Benefits, Enrollment, Claims, Sales & Marketing, Provider, Customer Contact, etc.,
- Do you have knowledge about health plan claims processing? Are you familiar with pricing, and adjudication of claims?
- Are you familiar with member enrollment in a health plan?
- Are you familiar with premium billing?
- Do you have knowledge of benefits configuration?
- Do you know what an 834 Enrollment transaction is?
- Do you know what an 837 Claim transaction is?
- Do you know what a 270/271 Eligibility Inquiry transaction is?
- Do you know what a 278 Authorization Request is?
- Do you know what a 276/277 Claims Status Request is?
- Do you have experience with Medicare?
- Do you have experience or knowledge of ACA line of business?
- Have you worked with or have knowledge of Medicaid or Commercial lines of business?
- Minimum of 8 years of experience in health plan technical projects
- Minimum of 5 years of experience architecture and implementing Health Plan automation solutions
- Minimum of 3 years of demonstrated experience in translating business strategies across several business units into effective technical solutions
- Bachelor's or Master's Degree in Computer Science, Math or related field.
- Self-directed and capable of working in a fast-paced, ambiguous environment
- Strong technical leadership and expert consultative and communications skills
- Significant enterprise expertise in developing and architecture solutions in a collaborative environment
- Substantial demonstrated experience in health plan technology and modernization of existing legacy solutions
Vacancy expired!