Business Solutions Architect - Healthcare (US Remote)

Company Description

The U.S. health sector is complex and dynamic - a vast and diverse network of entities that impacts the population and economy like no other industry. At USD$4.1 Trillion, healthcare spending represents nearly 18% of U.S. GDP. It is complex and inefficient. Health service buying, selling, and settlements have seen little change in the past decade despite clear changes in available information, technology, regulation, and market consolidation.

Enter MacroHealth. MacroHealth is a mission-driven company. We are building the most advanced and trusted market platform for health service payers and providers. The company’s vision is to create Intelligent Health Markets by building technology, knowledge and relationships that enable payers and providers to optimize the buying and selling of health services.

We are expanding our team of passionate thought leaders as we pursue our goal of disrupting the U.S. health sector with our vision and technology. We are committed to developing leading edge solutions in a supportive environment focused on customer success and employee fulfillment. 

Job Description

Summary of Opportunity 

MacroHealth has an exciting opportunity for an experienced Business Solutions Architect to join our team and help us bring a transformational solution to life for our healthcare customers. 

Using your significant healthcare Payer operations experience, you will act as a trusted advisor to MacroHealth clients and partners to accelerate their ability to implement new network/vendor relationships that add value to our clients and their constituents. Your detailed understanding of US Healthcare Payers, specifically enrollment, claims, pricing and clinical operations will make you a natural for this role. Among other duties, you will be responsible for defining and gathering healthcare operations related requirements to drive development of EDI, JSON and other types of application configuration. 

This position requires you to be a self-starter with the ability to take ownership, work with tight timelines, and handle various tasks simultaneously while continuing to develop a positive work culture. You will be part of a growing team of implementation experts driven to deliver consistently exceptional service to our clients. 

Key Responsibilities of Role: 

• Works closely with healthcare payers and provider networks to understand their operational requirements, allowing the creation of data exchange specifications to support healthcare data transformations 
• Documents client requirements and collaborates with team members to develop solutions that meet client-specific business needs 
• Translates client's business requirements into application configuration, workflows, business processes, and facilitates technical specifications 
• Leads clients through design and deployment of technical solutions 
• Creates and maintains implementation related documentation, such as business and functional requirements, process flows and configuration worksheets 
• Collaborates with other implementation team members and teams across MacroHealth to identify and develop solutions that deliver exceptional client value 
• Assist with the continuous improvement of implementation and service delivery best practices, processes, and tools 
• Communicates clearly and explains technical concepts in layman’s terms so that a non-technical audience can clearly understand what is needed for flawless implementations 
• Advocates for and evangelizes "best practices" to ensure long term success and value for MacroHealth and our clients 
• Builds and manages relationships at multiple levels of client organizations, from frontline staff to C-suite stakeholders 
• Collaborates with external client teams to understand evolving requirements/needs and communicate potential approaches to address them 
• Acts as a “trusted advisor” by payers and networks 

Salary Range: $110,000 - $125,000 USD per year

Qualifications

What You’ll Need: 

• 6 + years’ experience in health plan operations (can speak to how a health plan/payer operates), especially enrollment, utilization management, and claims pricing, processing and payment functions 
• 5 + years’ progressive client-facing implementation or operations experience 
• A working knowledge of general healthcare IT and data exchange (EDI) operations 
• BA/BS degree in information technology, business, healthcare administration or related discipline 
• Proven success in working with a team to collectively define, isolate, analyze, comprehend and solve complex issues 
• Empathy and a passion for problem solving 
• Outstanding planning, negotiating, and influencing skills 
• Ability to effectively prioritize and exec