Business Architect

Job#: 3041629

Job Description:
Business Architect

Location: Eagan, Minnesota (Remote)

Role Overview

We are seeking a Business Architect to provide strategic leadership for the Integrated Specialty business. This business-focused role is critical for aligning strategic objectives with operational execution. The position involves determining the future-state for fully integrated care management and requires a professional with superior communication, problem-solving, and end-to-end systems process experience.

Key Responsibilities

• Support the maturation of the business architecture practice.
• Partner directly with business owners and stakeholders to translate needs into conceptual models.
• Develop and apply capability models and architecture frameworks.
• Support strategic planning efforts, including future planning initiatives.
• Determine the future state for fully integrated care management.
• Operate effectively in an evolving and ambiguous environment.
• Collaborate with the Business Product Team, which will drive much of this role's work.
• Engage with senior leadership to define and align business strategies with operational plans.

Required Qualifications

Experience:

• 5-10 years of experience in PBM, preferably working with integrating Pharmacy and Medical Claims data.
• Strong understanding of PBM (Pharmacy Benefit Management) and Medical Pharmacy operations.
• Experience with healthcare technology solutions and healthcare data domains.
• Knowledge of when drugs are billed under pharmacy versus medical benefits.
• Familiarity with Prior Authorization, claims processing, eligibility data, and provider data.
• Understanding of compliance and regulatory requirements impacting PBM and Medical Pharmacy operations.
• Ability to engage confidently with business leaders and strategic stakeholders.
• Bachelor's degree in a relevant field such as Business Administration or MIS with 5+ years in business analysis, or 7+ years in business, solution, or enterprise architecture.

Preferred Qualifications

• Experience working within a business architecture framework or capability model (e.g., BACOE, ArchiMate, TOGAF).
• Experience in highly regulated industries such as healthcare, finance, or government.
• Healthcare claims experience.
• Product management exposure.
• Proficiency with Microsoft tools and platforms like ServiceNow and SharePoint.
• Experience with SAFe Agile, MITA, ITIL, and SDLC methodologies.

Work Environment

• The work schedule is Monday to Friday, anytime between 7 AM and 7 PM CST.
• This is a remote position.
• The role is part of a core team of approximately 3-4 people in a highly collaborative and horizontal environment.
• There is frequent interaction across multiple business and product teams.

Hiring Process

The hiring process will consist of a single round of interviews with the hiring manager and two other business subject matter experts.

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico.

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Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Everforth Apex team member can provide.

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

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