[Remote] Principal Solutions Architect - Claims Processing (Remote)

Note: The job is a remote job and is open to candidates in USA. CareFirst BlueCross BlueShield is seeking a Principal Solutions Architect to establish strategic technology direction and create solution architecture for large complex initiatives. The role involves translating business strategy into solution architecture, leading solution design and analysis, and ensuring effective communication and implementation of solutions.

Responsibilities

• Translate business strategy into solution architecture: Accountable for leading the Solution Architecture deliverables for large complex portfolio, program or product line, which aligns with enterprise architecture and links the high-level architecture, business requirements, and technology standards into a cohesive solution. Responsible for defining and communicating a shared technical and architecture vision across the portfolio/program. Provides foundational architecture and creates technical alignments for the full solution balancing the needs from both business and domain architecture. Has an expert knowledge of integration solutions and communicates with business owners, domain architects, other Solution Architects, technical delivery staff, and key technical stakeholders, including Security, Data, and Technology Centers of Excellence. Collaborates with peer Solution Architects to ensure that the proposed solution is consistent with other designs
• Leads solutions design incremental and analysis of complex projects/issues that require in-depth knowledge across multiple technical areas and business segments. Responsible for defining components and subsystem, end to end integration architecture and their interface, as well as the target deployment aligning with target architecture vision. Responsible for recommendations of critical design decisions and trade-offs. Ensures seamless integration of new applications with enterprise applications in the ecosystem by selecting the technology, tools or services that provides the best solution for business needs
• Accountable for communicating solution architecture and getting it implemented. Defines and directs implementation governance activities associated ensuing solution architecture compliance with the intent and overall enterprise architecture. Responsible for creates architecture and technical enablers to support architecture runways. Supports the implementation of enablers and ensures solution of technical and architecture enablers meet solution objectives
• Partners with the project manager, product managers technical delivery manager, requirements manager, and business leadership in the definition of the Solution Architecture.Work closely with product managers, product owners to ensure a robust architecture runways that can support future business needs through product lifecycle. Provide consulting supports to domain architects and solution delivery team to ensure project and product aligned with overall enterprise architecture
• Maintains knowledge of and apply industry best practices for architecture, participates in cross-functional component architecture teams, and develops future architecture and technology migration plans. Evaluates and selects from existing and emerging technologies options best fitting business and IT strategic needs

Skills

• Bachelor's Degree in Computer Science, IT related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
• 10 years' experience as an infrastructure architect
• Proficiency in innovating ideas and solutions resulting in tangible and measurable business outcomes
• Mastery in creating architecture solutions within the enterprise architecture future state for technological acceleration of value outcomes, and effectively present and persuade key decision makers to invest in this acceleration
• Must have recent solution/domain architecture experience with Facets G6 real-time and batch claims processing, pre-adjudication validation, EDI-based transaction data management, claim editing engines, and third-party integrations with partner organizations that provide these services
• Must have experience working with claims processing, enrollment, billing & payments, underwriting, partner programs, business operations, and benefit management business functions either in a commercial or government area (both preferred)
• Additional architecture experience in one or more technology platforms (Salesforce Health Cloud/Data Cloud, other Healthcare specific platforms, MuleSoft, Kafka, Azure Fabric)
• Expertise with two or more architecture domains (enterprise architecture, solution architecture, software development, data, integration, interoperability, cloud, artificial intelligence) and their associated architecture frameworks, standards/patterns, methods and tools
• Experience overseeing and driving third-party solution architecture engagements and outcomes
• Knowledge of healthcare data interchange standards (e.g., HL7, FHIR, X12) and regulatory requirements (HIPAA, CMS, NCQA)
• Experience contributing to portfolio rationalization and/or technical debt remediation initiatives at an enterprise level
• Ability to motivate and influence others so that architecture objectives are met in a timely and consistent manner
• Ability to collaborate with stakeholders to develop high quality, architecture solutions and technical designs based on approved standards
• Ability to coach peers and team members across multiple business and technology disciplines
• Ability to provide solution architectural consulting to business leaders, program leaders, product owners, and delivery teams
• Ability to set architectural solutions across multiple initiatives or domains aligned to platform/product roadmaps and facilitate implementation of approved solution
• Effective organizational/interpersonal/relationship management, analytical/systems thinking, communications (written and verbal) and collaboration across multiple business and IT teams
• Recent payer or provider healthcare experience a plus
• Must be eligible to work in the U.S. without Sponsorship
• Bachelor's degree in computer science or related field preferred
• Experience in the development, implementation, and maintenance of large-scale systems, preferably across multiple hardware and software platforms (in the health care industry)
• Experience with intranet development and implementation is a plus

Benefits

• CareFirst offers a comprehensive benefits package
• Various incentive programs/plans
• 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements)

Company Overview