Healthcare Payer Enterprise Architect
Req ID:
104536
NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us.
If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.
We are currently seeking a Healthcare Payer Enterprise Architect to join our team in Plano, Texas (US-TX), United States (US).
This position is fully Remote/Work at Home, with 25% travel post-COVID
Responsibilities:
- Provide strategic leadership for planning, designing, and implementing an enterprise architecture strategy, and implementation approach
- Maintain an ongoing partnership with customer s business and technical teams to apply in-depth knowledge of their operations, strategies, priorities, and information requirements to establish a technical direction with an enterprise view
- Evaluate emerging technologies, prototype solutions, and evaluate processes for inclusion in the technology road map e.
g.
microservices, cloud-native solutions - Establish and manage enterprise architecture development and governance processes
- Act as a visionary, championing content, storytelling, and leading digital innovation
- Ensure appropriate technical standards and procedures are defined.
Chair architecture-related review boards (enterprise/technical/solution/infrastructure) - Provide strategic guidance and research across all health plan domains such as Products, Benefits, Enrollment, Claims, Sales & Marketing, Provider, Customer Contact, etc.
, - Ensure architecture principles and best practices are adhered to in the adoption of new technologies
- Anticipate and react to major technology changes to ensure customer maintains leadership in the competitive landscape
- Provide architectural vision to appropriately align IT to strategic business needs
- Responsible for streamlining technology and ensuring projects are executed to meet business strategies
- Proactively recommend actions to maintain cost-effectiveness and competitiveness
We are looking for candidates with strong technical expertise and experience of having worked within a health plan.
They need to have knowledge of at least some of the following topics but need not be an expert.
- 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?
Basic
Qualifications:
- Minimum of 10 years of experience in health plan technical projects
- Minimum of 5 years of experience architecture and implementing Health Plan solutions
- Minimum of 5 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.
Preferred
Qualifications:
- 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
About NTT DATA Services
NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.
We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.
NTT DATA Services is an equal opportunity employer and will consider all qualified applicants for employment without regard to race, gender, disability, age, veteran-status, sexual orientation, gender identity, or any other class protected by law.
Estimated Salary: $20 to $28 per hour based on qualifications.
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