CNSI Looking for Business Solution Architect – Medicaid Claims Processing (Remote U.S.) at Remote Full Time

Job type full-time remote

Full job description

At cnsi, we are innovators, developers, engineers, and architects, who each play a vital role in our mission: empowering our clients to improve the health and well-being of one in five americansIf you want to join a company that uses technology to revolutionize healthcare, let’s talk!

What we do:

Cnsi is empowering the delivery of public sector healthcare in claims and encounter processing platforms, provider support solutions, and promoting consumer engagement and interoperabilityOur configurable, modular, scalable platform, evobrix x™, powers robust data analytics, risk reduction and regulatory compliance, and fiscal agent operations for our clients.

Cnsi`s technology-enabled products and solutions connect consumers, payers, and providers to improve health outcomes for one in five americans.

Cnsi is currently looking for an experienced business solution architect to join our growing team!

Summary:

The business solution architect is responsible for logical design and functional behavior of the solutions involving complex information systems for a system in claims, benefits administration, member eligibility, provider enrollment, prior authorization, third party liability (tpl) and/or contracts managed careAs the business architect, you will review, evaluate, and recommend solution for various business requirements; and provide a fully integrated solutionYou will collaborate with clients and stakeholders and use business modeling techniques to deliver effective “to be” operating models and roadmaps; and work to develop an integrated view of the solution and align project with the strategic business vision.

The selected candidate will be able to work remotely in the u.sWith up to 50% travel for client and team meetings, and trainingsCandidate located in the atlanta, georgia area preferred.

Responsibilities:

Acts as the requirements sme and elicit requirements working with client and stakeholders.
Evaluates requirements, transforms requirements to system functional requirements and business process requirements.
Works with customers on presenting technical solutions for complex business functionalities.
Provides customer support through leading client demos and presentations.
Leads team in applying in-depth healthcare claims and encounter, member eligibility & enrollment, or managed care domain knowledge to review and analyze systems problems.
Escalates issues and risks to manager and assists in developing solutions.
Collaborates with technical architect, business analyst, technical lead, and stakeholders translate business and system functional requirements to implementable components.
Identifies potential system impacts due to proposed system function implementation.
Identifies gaps and deviation within product versus client business requirements and supports change management.
Develops prototype, proof of concept, wireframe models to demonstrate solution as applicable.
Identifies areas for process improvement to improve quality and optimize cost.
Keeps abreast of new technology and market developments (including federal regulations) and suggests adoption of new technologies and tools to improve quality of business solutioning and related deliverables.
Determines optimized solution by conducting decision analysis and resolution on possible solutions.
Assists in facilitating proposal development by providing technical solution write-ups and pricing estimates.

Required experience/skills:

Bachelor`s’ degree with 12+ years of business solutioning or related experience or master`s degree with 10+ years of business solutioning or related experience.
5+ years of experience of medicare, medicaid and/or healthcare verticals project experience.
Proven record of knowledge in medicaid management information system (mmis) around claims processing and related subsystems.
Successful track record of customer relation communications including presentation and meeting facilitation.
Experience leading and mentoring team that facilitates and run jad requirements design sessions, etc.
Proven record of requirements elicitation and validation skills, including experience with systems development life cycle (sdlc).
Demonstrates advanced expertise and contributes to the solution architecture practice by publishing technology points of view through the creation of white papers.
Strong technical knowledge and proficiency in sql.
Knowledge of data integration and software enhancements/planning.

Preferred experience/skills:

Bachelor’s degree in computer science, engineering, business administration, or a closely related field
Knowledge of quality-of-care program.
5+ years of architecting experience of medicare, medicaid and/or healthcare verticals with large projects.
Business analysis certificate

About us:

At cnsi, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costsWe’re passionate about helping our clients improve the health and well-being of individuals and familiesWe succeed when our clients succeed.

Innovation and commitment to our mission are core to our dnaAnd through our shared values, we foster an environment of inclusion, empowerment, accountability, and fun! you will be offered a competitive compensation and benefits package.

Cnsi is an equal opportunity employerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status, genetic status, family responsibilities, protected veteran status, or any other status protected by applicable federal, state, or local lawWe are proud of our diversity and encourage all qualified applicants to apply.

Kindly inquire during the interview process if this position is subject to president biden’s executive order on ensuring adequate covid safety protocols for federal contractors, requiring you to be vaccinated by december 8, 2021.

#li-sd1

Equal opportunity employer/protected veterans/individuals with disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicantHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information41 cfr 60-1.35(c)

Hiring insights

Job activity

Posted 30+ days ago