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Healthcare Payer Enterprise Architect

Company: NTT DATA Corporation
Location: Plano
Posted on: June 8, 2021

Job Description:

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.

Keywords: NTT DATA Corporation, Plano , Healthcare Payer Enterprise Architect, Other , Plano, Texas

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