Job ID: NC-632500 (91190814)
Medicaid/MITA Architect with BA, PM, BI/data analysis, UCD, agile, MMIS and Managed Care System/claims processing experience
Location: Raleigh NC (DHHS)
Duration: 12 months
Positions: 1 (1/2)
Skill Required / Desired Amount of Experience
Extensive Knowledge of Medicaid and Managed Care systems or solutions Required 7 Years
Extensive Knowledge of the MITA Business, Information and Technical architecture framework Required 5 Years
In-depth knowledge and understanding of products, systems, and solutions across functions and business segments in healthcare Required 7 Years
Experience directing the conception, development and implementation of new product initiatives, including enhancements, and platform migrations Required 5 Years
Demonstrated ability to establish cross-functional workgroups that provide effective definition and oversight of the Medicaid Business Architecture Required 7 Years
Extensive experience in development of Executive Level Business Presentations, Business Case Justifications and Performance Metric Development Required 5 Years
Excellent verbal and written communication skills with the ability present to both technical and business audiences. Required 7 Years
Knowledge of user centered design (UCD), product management, project management methodologies, and requirements elicitation Required 5 Years
Extensive familiarity with business intelligence, analytical and reporting tools, and data analysis Required 7 Years
Experience in the implementation of an MMIS, or other cloud based health care claims processing or eligibility system project Highly desired 5 Years
Experience participating or leading projects using an Agile methodology in coordination with a Systems Integrator Highly desired 5 Years
NC Department of Health and Human Services (DHHS) Information Technology Division (ITD) is seeking a Business Integration Architect (BINA) to perform work for the federally-required Medicaid Enterprise System implementation project. The Business Integration Architect will serve as a member of the Medicaid Enterprise System (MES) Program providing strategic leadership that translates technical and business strategies to maximum productivity commensurate with the best interest of NC Medicaid. This role will provide oversight which may include development and monitoring of the Medicaid Managed Care implementation methods, while collaborating with other DHHS divisions and external stakeholders to develop and implement targeted strategies to streamline processes. This resource will lead the review of the Business Architecture efforts across the multi-payer DHHS organization. This individual is also responsible for evaluating the methods (how the business architecture is developed and used), artifacts (what information is gathered, modeled and retained), culture (attributes of the people that encompass the landscape) and environment (the tools and frameworks used to perform the methods). The BINA will be responsible for reviewing the identification and analysis of enterprise business drivers to derive useful business context. This position will work to promote the integration of system enterprise process, outcomes and results to the organization, including the executives, business leaders and IT leaders. The role will make recommendations that help refine the organizational requirements for the resources, structures and cultural changes necessary to support the technical architecture. This position will also support the development of roadmaps for the operational readiness and change management plans based on business priorities and IT strategies. This role will also champion Business User Acceptance of MES module solutions alongside addressing any Medicaid Information Technology Architecture (MITA) state self-assessment activity required to further define the Business Architecture for the Medicaid program to align with CMS requirements.
Knowledge, Skills, and Abilities Requirements:
• Extensive Knowledge of Medicaid and Managed Care
• Extensive Knowledge of the MITA Business, Information and Technical architecture framework
• Extensive experience in development of Executive Level Business Presentations, Business Case Justifications and Performance Metric Development
• In-depth knowledge and understanding of products across functions and business segments in healthcare that meet departmental goals.
• Experience directing the conception, development and implementation of new product initiatives, including current product enhancements.
• Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for product solutions.
• Establishes cross-functional workgroups that provide effective oversight of the Medicaid Business Architecture
• Understands project portfolio management processes and deliverables, project management methodology, and business requirements elicitation techniques and documentation.
• Collaborates and develops workgroups around product deliverables with Business Owners/Leads, Product Managers, Architects, Technical Leads and Program Management.
• Communicate project goals and timelines, next steps and results to team members, project managers and the executive team.
• Through a variety of communication/meeting methods, determines the customer’s needs, leads product discovery and translates these into detailed and actionable requirements
• Experience in analysis of performance indicators and evaluation of survey data to define successful criteria for testing and product acceptance.
• Knowledge of the Medicaid Enterprise Systems (MES), cloud technologies, and system integration
• Has an understanding of CMS Seven Standards and Conditions
• Experience in the implementation, operations, and maintenance of an MMIS, or other health care claims processing or eligibility system project;
• Knowledge of Federal and State procurement and contract policies statutes, rules and regulations
• Ensures compliance with all applicable policies and procedures.
• Fluently discuss the financial and/or operational benefits associated with proposed product capabilities.
• Professional demeanor; ability to establish rapport and work well with others
• Performs other duties as assigned which may include managing direct and hybrid reporting relationships of subordinate staff
In addition the Business Integration Architect will expressly engage with the business owners to develop the strategy behind how each MES module will support the business requirements definition and will aid in the translation and specification of all functional requirements. The BINA will work integrally as a member of the Business Integration Program Management team alongside IT Product Managers, IT Architects, Business Technology Relationship Management, and the MES Integrator to manage the launch of features and systems and ensure business outcomes are represented and realized. This role will evaluate and analyze work done by Medicaid SMEs, Business and Technical Leads, Data Leads, Engineers, and Architects to ensure the business requested capability, implemented design, and delivered functionality is successful and useful to the stakeholders.