Lead Business Architect -CMS Enterprise APIvirtual remote home office

Profile

Description

The Lead, Business Architect as part of Humana's Enterprise API product team, is directly responsible for providing insight, advisement and direction to teams responsible for Enterprise API catalog, developer experiences, and integration systems. Individual will be leveraging previous healthcare experience to aid in the discovery, design, implementation, and presentation of current and future state workflows & Architectures in an effort to provide simple and efficient member experiences.

Responsibilities

Responsibilities:

Participation and accountability in the overall strategy and direction of Humana's Enterprise API portfolio and deeply involved thought leader within multiple business and IT segments

Influencing the direction, design and implementation of new process, workflows, architectures and experiences

Aiding in analyzing, assessing and auditing Enterprise API content in assuring alignment to business, IT and regulatory standards

Proactively detecting issues and identifying solutions with directly responsible Individuals

Continuously researching, synthesizing and presenting latest industry standard, policy, and regulation to the collective Enterprise API & Integration teams

Education/Experience:

Bachelors degree

3 years of related experience supporting large-scale Healthcare payers

Direct experience working in or with healthcare payers and providers for multiple lines of business: Medicare, Medicaid, Commercial - Individual & Group, etc

In-depth knowledge and work experience in two or more of the following healthcare functions such as1. Member eligibility or enrollment2. Provider data management3. Clinical care or utilization management (UM)4. HEDIS Quality measurements5. Value-based care6. Regulatory and compliance7. Claims management

Deep understanding of insurance and clinical process flows, systems and operational procedures

Heightened awareness of healthcare best practice and industry standards in order to directly influence future state direction

Strong experience in creating, capturing, and analyzing business and/or IT requirements and mapping them to existing or future state workflows and architectures

Proven ability leading cross-functional design & discovery sessions to help identify existing problems, collaborate on potential solutions, and map to desired business processes based on Enterprise technology roadmap

Understanding of advanced analysis processes including opportunity assessments, trend identification, and gap analysis

Required Qualifications

Bachelor's degree

Solid understanding of operations, technology, communications and processes

Possess 8 years of progressive experience leading continuous improvement efforts, evaluating existing systems and implementing process improvements.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Master's degree

Additional Information

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com