Lead Business Architect - Enterprise API

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Job Information

Humana

Lead, Business Architect - Enterprise API

in

Portland

Maine

Description

The Lead, Business Architect as part of Humana's Enterprise API product team, is directly responsible for providing insight, advisement and direction to teams responsible for Enterprise API catalog, developer experiences, and integration systems. Individual will be leveraging previous healthcare experience to aid in the discovery, design, implementation, and presentation of current and future state workflows & Architectures in an effort to provide simple and efficient member experiences.

Responsibilities

Humana is seeking a Lead, Business Architect that will be responsible for:

Participation and accountability in the overall strategy and direction of Humana's Enterprise API portfolio and deeply involved thought leader within multiple business and IT segments

Influencing the direction, design and implementation of new process, workflows, architectures and experiences

Aiding in analyzing, assessing and auditing Enterprise API content in assuring alignment to business, IT and regulatory standards

Proactively detecting issues and identifying solutions with directly responsible Individuals

Continuously researching, synthesizing and presenting latest industry standard, policy, and regulation to the collective Enterprise API & Integration teams

Education/Experience:

Bachelors degree

10 years of related experience supporting large-scale Healthcare payers

Direct experience working in or with healthcare payers and providers for multiple lines of business: Medicare, Medicaid, Commercial - Individual & Group, etc

In-depth knowledge and work experience in two or more of the following healthcare functions:1. Member eligibility or enrollment2. Provider data management3. Clinical care or utilization management (UM)4. HEDIS Quality measurements5. Value-based care6. Regulatory and compliance7. Claims management

Deep understanding of insurance and clinical process flows, systems and operational procedures

Heightened awareness of healthcare best practice and industry standards in order to directly influence future state direction

Strong experience in creating, capturing, and analyzing business and/or IT requirements and mapping them to existing or future state workflows and architectures

Proven ability leading cross-functional design & discovery sessions to help identify existing problems, collaborate on potential solutions, and map to desired business processes based on Enterprise technology roadmap

Understanding of advanced analysis processes including opportunity assessments, trend identification, and gap analysis

Required Qualifications

Bachelor's degree

Solid understanding of operations, technology, communications and processes

Possess 10 years of progressive experience leading continuous improvement efforts, evaluating existing systems and implementing process improvements.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Master's degree

Additional Information

For this job, associates are required to be fully COVID vaccinated (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com