Healthcare CRM Architect

Job Title: Healthcare CRM Architect

Client: Blue Cross Blue Shield of Massachusetts

Location: Remote

(candidates must have healthcare insurance experience. Need experience working in healthcare payer (sometimes spelled payor) systems)

Healthcare CRM SME/Architect

Summary / Objective:
This key position leads the strategy and integration for healthcare call center systems. As a solution architect requires knowledge of CRM implementation and Subject Matter Expertise (SME). We are looking for someone comfortable stepping into a leadership role in which they would be empowered to drive initiatives from a concept to a delivered product with minimal supervision, providing guidance and direction to others on the team.
Top-3 requirements for the role

1. Strong knowledge of CRM - SFDC / MS Dynamics
2. Experience in Implementing Industry standards.
3. Solution architect with work experience in Healthcare Payers systems

Key Competencies:

• Brings architecture alignment, provides governance, and participates in technical review meetings at the team and enterprise level to help finalize design decisions and solution architecture with leadership team.
• Specific functions of this role include business process definition (as-is vs. to-be), solution design, configuration, and implementation of technical solutions across the CRM platform.
• The Healthcare SME/Architect plays a key role in IT/CRM strategy and acts as a visionary to leverage industry best practices, Standards, evaluating current state and recommendations.
• Partner with Stakeholders such as Customer Care, Marketing, R&D, Business Operations, Sales, and Information Technology to drive high levels of data integrity and operational reliability of our standardized business tools and processes.

Essential Functions:

• This Individual will keep abreast of new Salesforce /other CRM Call center features and functionality to provide recommendations for process improvements and technical updates to ensure alignment with business/technology strategy and planned initiatives.
• Drive business requirements, investigate solution design, document complex user flows, and ultimately help with the implementation/delivery of service /Call center CRM solutions.
• Develop and create customized reports and dashboards based upon the needs of business unit partners.
• The customer experience group is also exposed to a wide variety of projects across our applications such as Mobile Platforms, Patient Portals, and Digital Health.
• Translate business and technical requirements for integrations into an architectural blueprint/roadmap to achieve business objectives. Understand needs and define efficient, scalable, and high-performance enterprise-level integration solution architecture and design.
• Experience in healthcare payer and domain expertise in one or more of claims,

Technology Experience:

• Experience using any one of CRM products & tools. Knowledge of SFDC contact center, Healthcare call center experience is a plus.
• Experience in healthcare industry and domain expertise in one or more of claims, Enrollment, Call center, Eligibility, Referrals and Authorizations.
• Strong prior development background building enterprise integrations using Java, Java EE, Spring, Spring Boot, Spring Cloud services.
• Knowledge and experience with CI/CD tools, frameworks, and methodologies like Jenkins, maven, Jira, ServiceNow, GitLab, Junit, Blue/Green etc.
• Experience working with Agile methodologies (Scrum, Lean Startup, XP) and cross-functional teams (Product Owners, Scrum Masters, Developers, Designers, Business Analysts)

Preferred Education and/or Work Experience:

• Bachelor's degree in computer science or equivalent is required. Master's degree is a plus.
• Minimum of 8 years of technology experience
• Cloud & Agile certifications e.g., AWS Developer or CRM technical architect certifications
• Healthcare payer experience and handling healthcare call center