Departmental Summary: * Individual will work alongside architecture to define future state and translate the outcomes to tactical activity with support from analysts, technical leads and delivery. * Our department is emphasizing the need for strategic thinkers. The world of PI is changing rapidly and will continue to do so for many years to come. Departmental Preferences: * Demonstrated experience leading or contributing to the strategic vision and future state definition of a significant claims processing solution * Ability to define and clearly communicate a path from current state to the future state solution, bridging strategic vision to tactical execution * Experience and knowledge of IT infrastructure, architecture and application development * 7-8 years claims processing experience on a payer health insurance platform, preferably NASCO or Facets * 2-4 years of experience with vendor integration to payer platforms * Understanding of the Claim payment continuum including Clinical Editing and Payment Integrity * Demonstrated experience with leading problem-solving exercises and presenting out-of-the-box alternatives * Experience in Visio/other process flow software Maintain the broadest range and depth of knowledge in their respective area of expertise within the IT organization. Stay abreast of emerging technologies and influence strategic decisions regarding technical direction of the business. Consult on multiple projects/programs as a subject matter expert of existing technology; on and helps drive new technology direction; on cross-divisional technology solutions; and on highly complex tasks, projects/programs or support issues that involve a high degree of risk or impact to business unit performance and has a high level of knowledge within one or more areas of specialty. * Interface with users and IT teams to evaluate possible implementation of new or enhanced technology in the organization, consistent with the goal of improving existing systems and technologies and in meeting the needs of the business. Provide technical expertise across business and IT functions. * Partner with leadership to define and communicate long-term technology strategy and planning for a specific area. Participate with business relationship managers and business leads to understand business requirements and help them understand how technology tradeoffs influence strategy. Drive technology improvements. * Make recommendations and influence long-term technology decisions and planning for multiple business units. Assist in the definition of the architecture and technology needs of the organization based on new and emerging technologies, and establish priorities and strategies consistent with business goals and economic viability. Consult in the development and analysis of source selection strategies. Recommend and incorporate technology with long-term business plans. * Consult in the development of responses to customer requests and proposals as needed. Consult on the technical aspects of strategic projects/programs. Provide technical guidance to customers and internal IT staff in the design and development of fully integrated technology solutions. Influence the design of innovative solutions using new technologies. Review proposed designs at key milestones and makes recommendations as needed. Ensure the conceptual completeness of the technical solution. Create prototypes, lead initial development and testing as needed. * Consult on the resolution of high severity issues or issues escalated by senior leadership. Collaborate with internal or external parties during the problem resolution process as needed. Provide technical leads, delivery leads, and IT Leadership with technical consultation and advice. Keep IT's technology and application owners aware of key issues. Identify and resolve potential problems and conflicts in technology. Advise on options, risks, costs versus benefits, system impacts, and technology priorities. Transfer knowledge of key learning throughout the enterprise, and communicates strategic and technological plans. Interface/communicate with the Architecture group. Partner with and acts as an advocate for Architecture. Present technical plans in common terms to ensure understanding from all audiences. * Lead the collaboration of research and evaluation of emerging technology, industry and market trends, as needed. Assist in project development and/or operational support activities as needed. Research, collect, and disseminate information on emerging technologies and key learning throughout the enterprise. Research and recommend changes to enterprise architecture. * Support and may drive research analysis and A&P projects to identify and evaluate emerging technologies. Research and evaluate emerging technology, industry and market trends to assist in project development. Provide recommendations based on business relevance, appropriate timing and deployment. Analyze and research process of deployment and assists in this process. Assist in cost-benefit and risk analysis and present options to leadership teams. Oversee cost-benefit and risk analysis and presents options to leadership teams as needed. Represent the organization in relevant industry forums. * Provide coaching, mentoring and technology guidance across the organization(s). Other duties may be assigned. "Qualifications" EDUCATION AND/OR EXPERIENCE * Bachelor's degree in computer science, information systems, computer engineering, systems analysis or a related discipline required. Master's degree preferred. * Seven (7) years of experience in multiple technology areas required. * Demonstrate strong knowledge in one or more major technology areas knowledge of BCBSM business required. OTHER SKILLS AND ABILITIES * Decision making and strategic and critical thinking skills. * Must influence people over whom they have no direct control, as they help define strategic technical and business plans. * Ability to utilize assigned resources and leverage back-channel resources (individuals or teams) to achieve or exceed planned outcomes. * Other related skills and/or abilities may be required to perform this job. All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
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