Principal Business Architect

Summary

As a Principal Business Architect at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

At Gainwell, it’s easy to see the positive impact of what we do. The passion you bring to your career ultimately benefits the lives improved by services we provide to our clients. We encourage you to challenge yourself, learn and grow in a company that thrives on innovation. We go beyond entering new arenas to shaping markets with transformational experiences that redefine our business. The difference is clear.

Your role in our mission

Essential Job Functions

• Defines and manages the architectural roadmap for one or more platforms, products or services. Provides subject matter expertise in how business capabilities interact with technical capabilities to address client business problems and achieve client goals.
• Provides direction for project and program design activities to ensure that both customer and company business objectives are met. Collaborates and/or partners with business and technical architects to ensure initiatives align with business and information technology improvement strategies.
• Conducts and/or participates in customer's process analysis in order to understand business complexities and constraints and recommends technical improvements. Evaluates existing process, and recommends and implements improvements.
• Enables cross-functional teams to work in parallel by providing guidance and direction in support of business solution architecture.
• Supports, resolves and documents issues that arise in the architecture. Reviews designs and recommends improvements to the architecture. Works with the customer to eliminate gaps and inconsistencies in the business solution architectural design and to ensure that none develop over time.
• Reduces client risk by ensuring that recommended business solutions meet customer's price, scope, and time requirements.
• Uses professional concepts in developing resolution to critical issues and broad design matters.
• Maintains awareness of trends, best practices and standards for the industry and related technology fields. Introduces new technology processes as appropriate.
• Provides leadship and work guidance to less experienced personnel.

What we're looking for

• Eight or more years of business analysis, business re-engineering, business transformation, financial analysis, business architecture or related experience
• Highly skilled in eliciting User Demands, managing User Requirements and translating them into functional and design specifications.
• Experience working with business process, information modeling tools and techniques, company products, operating systems and client business processes
• Experience working with requirements elicitation techniques including conducting user interviews, document analysis and JAD sessions.
• Extensive knowledge in the following areas
  • Claims management including inpatient, outpatient, long term, professional, dental and pharmacy claims
  • Understanding X12 and X12 manipulation of all above claim types.
  • Electronic visit verification (EVV)
  • Inpatient acute care claims processing with APR DRG
  • Prior Authorization subsystem
  • State sponsored social services (waiver programs)
  • MAR reporting to CMS

What you should expect in this role

• Fast-paced, challenging and rewarding work environment.
• Remote work
• Video cameras must be used during all interviews, as well as during the initial week of orientation