Enterprise Architect

5 hours ago

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HealthEdge

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Healthcare Insurance • SaaS • Fintech

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

1001 - 5000 employees

Founded 2005

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

📋 Description

• Lead client discovery sessions and translate business requirements into technical strategies • Serve as primary technical advisor to executive-level stakeholders • Support pre-sales engagements including RFP responses, demonstrations, and proposals • Develop resource (FTE) estimates and financial projections for implementations • Create statements of work and support contract negotiations • Contribute to thought leadership content supporting business development • Design enterprise integration architectures spanning multiple core administration platforms • Evaluate technology approaches across healthcare ecosystem platforms • Develop comprehensive solution documentation including architecture diagrams and technical specifications • Assess technical feasibility and business impact of proposed solutions • Supervise and mentor 2-4 Solution Architects • Review and approve technical designs developed by team members • Foster collaborative, learning-focused team culture • Conduct regular one-on-ones and performance reviews • Establish and enforce architecture standards and best practices • Ensure solutions meet security, scalability, performance, and compliance requirements • Drive repeatability and reusability of integration patterns • Lead architecture review boards and technical design sessions

🎯 Requirements

• Bachelor's degree in business, computer science, or technical field • Minimum of 20 years in healthcare technology integration • Minimum of 10 years in technical leadership roles • Minimum of 5 years people management experience with direct reports • Proven track record of large-scale health plan implementations • Expert knowledge of payor operations across Medicare Advantage, Medicaid, and Commercial • Deep experience with core administration platforms (HealthEdge, TriZetto, NASCO, Change Healthcare) • Extensive EDI transaction integration experience (837, 834, 835, 270/271, 276/277, 278) • Understanding of healthcare standards (HL7, FHIR, X12, NCPDP, ICD-10) • Knowledge of CMS and state regulatory requirements • Exceptional analytical abilities and strategic thinking • Outstanding communication skills for technical and executive audiences • Proven ability to support sales cycles including proposals and presentations • Experience with AWS cloud environments and modern cloud services • Knowledge of SQL, Java, Spring Boot, Web Services, XML, JSON • Familiarity with Agile methodologies and CI/CD pipelines • Experience working in onshore/offshore delivery models • Comfortable in fully remote environment with strong collaboration skills.

🏖️ Benefits

• HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. • We aspire to have an inclusive workplace. • We aspire to be a place where all employees have the opportunity to belong, make an impact and deliver excellent software and services to our customers.