M&R Enterprise Architect

Overview

Remote
Depends on Experience
Contract - W2

Skills

Enterprise Architect
Healthcare

Job Details

Position Title M&R Enterprise Architect

Domain EXP (Healthcare Domain)

Location Remote

Duration 6 Months

Must Have Architect - COSMOS to GCO Claims (ETL, Cloud, Microservices, Kafka, DevOps, Open Source, Spring Boot)

Job Description

Description of work and details on what requested resource(s) will be doing:

These resources will be providing architectural support for Project Bolt through impact analysis, solutions, alignment with M&R level strategies and works with Business, Engineering and collaborates with Enterprise/Application Architects from COSMOS to GCO Claims.

Deliverables

  • Align business and IT strategies, assess business and other IT ideas, and create strategy for the program.
  • Develop conceptual/reference architectures, and blueprints for alignment between M&R and enterprise strategies.
  • Produce solution intent document for the individual projects under Bolt and how they allcoexist in the broader scope of project bolt and review with all stake holders for their approval
  • Help prepare materials for Capital Planning and present at Architecture Review Boards
  • These programs help M&R business with
  1. Trial Claims: Enable non-real-time trial claims for all claims platform
  2. Provider Pick: Migrate M&R provider selection from COSMOS to Enterprise Provider Selection (real-time); enhance EPS
  3. Benefits: Consolidate BenCheck with Pre-D
  4. Auth: Integration with CCAM,
  5. Pricing: EPP Implementation
  6. Accumulators: Externalize data to HCP for real-time access
  7. Claim Messaging: Connect claim message center to COSMOS; optimize remark codes; add new messages for trial claims/promises
  8. Payment & Presentment: Connect COSMOS to Payment Engine

Key Skills / Experience:

  • 8-10 years of enterprise architecture experience and well versed with enterprise architecture practices
  • Experience with Cobol, JCL, MF Cobol, API, Kakfa, Azure cloud platform
  • Ability to work with multiple stake holders in a matrixed organization
  • Deep understanding of application interactions and patterns
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