Business Architect Senior optimizing healthcare claims processes at Elevance Health. Collaborating on system enhancements, investigating root causes, and contributing to enterprise architecture.
Responsibilities
Support Cost of Care and other provider-based root-cause investigations leveraging intimate provider system and business process knowledge to audit system configuration and E2E inventory lifecycle for potential errors
Conduct sophisticated data & analytics reports and synthesize findings on root-cause contributors and organizational and/or stakeholder experience impact
Recommend process and system enhancements based on system root-cause findings
Provide linkages to other Enterprise Architecture groups and models, coordinate and align activities to achieve the future state capabilities with Business Relationship Management (BRM)
Contributes to providing linkage to other Enterprise Architecture groups and models
Leads Reference architectures, Strategic Business Architecture (SBA) and Operational Business Architecture (OBA) that articulate a future state direction to optimize the value chain
Creates initiatives to perform enterprise wide functional analysis to identify areas for efficiencies or rationalization opportunities
Reviews a common process for how projects are assessed against business architecture artifacts and blueprints
Translates strategic decisions into operational and process-focused plans for a market segment
Requirements
Requires an BA/BS degree in Information Technology, Computer Science or related field of study
minimum of 7 years experience in business analysis and strategic planning, IT operations, IT planning, IT leadership, or strategic and technical architecture
Prior Elevance Health experience strongly preferred
Prefer knowledge of the following systems: EDI/EDINET; SQL; JIRA; FACETS (CENTRAL/GBD); BlueSquare, WEBSTRAT; Authorization Overwrite Tool (AO Tool) .Net UI; Claims Workstation Pega UI
Strongly prefer knowledge in claims processes and data
Experience in health care industry strongly preferred
Enterprise Architecture related certifications strongly preferred
Benefits
merit increases
paid holidays
Paid Time Off
incentive bonus programs (unless covered by a collective bargaining agreement)
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