Payer Systems – Integration Architect

Job not on LinkedIn

🕒 June 25

☕ Washington – Remote

☕ Washington – Remote

💵 $130k - $182k / year

⏰ Full Time

🟠 Senior

🔴 Lead

⚙️ Systems Engineer

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MCG Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

Healthcare Insurance • SaaS • Enterprise

MCG Health is a company that provides evidence-based clinical decision support and care management solutions for healthcare organizations. They offer software and services that help payers, providers, and patients make informed and effective care decisions. MCG Health works with government healthcare agencies, provider networks, and healthcare software vendors to integrate their guidelines into clinical workflows and utilization management. Their solutions are designed to help improve patient outcomes and streamline care coordination across various healthcare settings.

📋 Description

• 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.

🎯 Requirements

• 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

🏖️ Benefits

• 💻 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/