Payer Systems – Integration Architect

Vaga não está no LinkedIn

🕒 Junho 25

☕ Washington – Remoto

☕ Washington – Remote

💵 $130.000 - $182.000 / ano

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

🏛️ Arquiteto

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

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MCG Health

SiteLinkedInTodas as Vagas

201 - 500 funcionários

💼 Consultoria

🛡️ Seguros

📦 Logística

Consulting • Insurance • Logistics

A MCG Health é uma empresa que fornece suporte à decisão clínica baseado em evidências e soluções de gestão de cuidados para organizações de saúde. Eles oferecem software e serviços que ajudam pagadores, provedores e pacientes a tomarem decisões de cuidados informadas e eficazes. A MCG Health trabalha com agências governamentais de saúde, redes de provedores e fornecedores de software de saúde para integrar suas diretrizes nos fluxos de trabalho clínico e na gestão de utilizações. Suas soluções são projetadas para ajudar a melhorar os resultados dos pacientes e otimizar a coordenação de cuidados em diversos ambientes de saúde.

Descrição

• Serve as MCG’s principal subject matter expert and escalation authority for payer workflows, interoperability, integration architecture, and healthcare data flows across customer implementations and internal initiatives. • Lead complex workflow discovery and implementation advisory engagements to define integration strategies, clarify operational requirements, and guide solution design within diverse payer environments. • Advise implementation teams and customers on how MCG solutions integrate into complex payer operational and technical ecosystems, including utilization management workflows such as prior authorization. • Identify and resolve highly complex workflow, interoperability, and integration risks, gaps, dependencies, and implementation challenges, recommending scalable mitigation strategies and alternative approaches where standard solutions are insufficient. • Partner cross-functionally with Product, Engineering, Implementation, Sales, and customer stakeholders to align solution design, integration strategy, technical dependencies, and implementation execution. • Translate complex operational and technical concepts into clear, actionable guidance for technical teams, business stakeholders, and customers. • Facilitate working sessions with internal teams and customers to align on workflows, integration points, data dependencies, interoperability considerations, and implementation approaches. • Establish and evolve scalable implementation frameworks, standards, reusable assets, workflow models, and best practices that improve consistency, predictability, and organizational capability across payer integration engagements. • Analyze implementation trends and recurring workflow or interoperability challenges to identify opportunities for process improvement, scalability, and operational efficiency. • Provide expert consultation and real-time workflow and integration guidance during customer engagements, reducing dependency on Product and Engineering resources for operational interpretation and implementation support. • Provide functional leadership, mentorship, and subject matter guidance to implementation team members on payer operations, interoperability concepts, integration strategy, and complex issue resolution. • Serve as a senior advisor during customer strategy and pre-implementation discussions to assess feasibility, clarify integration considerations, and align implementation expectations. • Provide customer-driven feedback to Product and Engineering teams regarding workflow gaps, interoperability challenges, implementation friction points, and enhancement opportunities. • Develop knowledge aids and support cross-functional enablement efforts to strengthen payer workflow and integration knowledge across implementation and customer-facing teams. • Use AI-enabled tools and technologies appropriately to improve implementation efficiency, workflow analysis, documentation quality, and knowledge-sharing while ensuring accuracy, security, and alignment with organizational standards.

🎯 Requisitos

• Bachelor’s degree in Healthcare Administration, Information Systems, Computer Science, Business, or a related field, or equivalent combination of education and experience • At least 8 years of experience working with health plan (payer) systems, workflows, operations, and healthcare integrations • Demonstrated experience leading or advising complex healthcare implementations, workflow transformations, or integration initiatives within payer environments • Strong understanding of end-to-end healthcare workflows, particularly within payer operational settings • Demonstrated expertise with healthcare interoperability, system integrations, and data flows across multiple platforms and technologies, including APIs, HL7, FHIR, or related standards • Proven ability to analyze, interpret, and translate business, operational, and technical requirements into scalable implementation guidance and solution approaches • Demonstrated experience navigating highly complex or ambiguous payer operational and integration environments and developing effective solution strategies • Experience working cross-functionally with technical, operational, product, and business stakeholders in matrixed environments • Demonstrated ability to diagnose highly complex workflow and integration issues and recommend effective, scalable solutions • Experience influencing technical and operational decisions without direct authority • Strong communication skills, including the ability to engage effectively with both technical and non-technical audiences • Experience facilitating customer-facing discussions involving technical workflows, interoperability, and implementation strategy

🏖️ Benefícios

• 💻 Remote work • ✈️ Travel expected 3-4 times per year for company-sponsored events • 🩺 Medical, dental, vision, life, and disability insurance • 📈 401K retirement plan; flexible spending and health savings account • 🏝️ 15 days of paid time off + additional front-loaded personal days • 🏖️ 14 company-recognized holidays + paid volunteer days • 👶 up to 8 weeks of paid parental leave + 10 weeks of paid bonding leave • 🌈 LGBTQ+ Health Services • 🐶 Pet insurance • 📣 Check out more of our benefits here: https://www.mcg.com/about/careers/benefits/