As a direct contributor with no direct reports, the Solutions Architect works closely with customers, business analysts, and team members to understand complex business requirements that drive the analysis and design of effective technical solutions for business processes. These solutions must be aligned with business and IT strategies and comply with the organization's architectural standards and QNXT application platform.

The Solutions Architect designs and ensures that all aspects of the application solution architecture are optimized (for time and budget) by working with other subject matter experts (SME) in the areas of technology, information and application disciplines. Focuses on designing QNXT application interfaces and software services to maximize reuse based on business processes and governance rules of sharing. Will also provide the reusable standards, guidelines, patterns to application development projects, including those related to application architecture. In partnership with business units, designs, prepares and executes upgrades and enhancements to the systems as technology evolves.

Primary Responsibilities:

• Designs, develops, implements and supports the C#, ASP.NET, ANSI, XML, HL7, SQL Server and SSIS applications.
• Works in designing applications that align with the Medicare standards and can adapt and adheres to the Medicare policies and procedures. Developing applications and data layers that can interact with the CMS and HPMS systems.
• Leads and facilitates architectural discussions and follow ups to propose options and recommended solutions including product evaluation and propose buy vs. build recommendations.
• Conducts the design and code reviews (peer review and/or group reviews) in order to identify the potential issues upfront.
• Works directly with the Business Analyst group to review and amend requirements and to propose the most optimized solution to the business process including impact analyses on existing systems like QNXT, QConnect, and CCA.
• Utilizes expertise with integrated healthcare systems to provide technical guidance to the development and/or support team, coding and troubleshooting in SQL, C#.NET, and Visual Studio.
• Utilizes expertise with Object Oriented Software Development, Relational Database Programming, Centralized User Identity Management and Multi-tiered Application Integration.
• Works with hosted vendors to accomplish SDLC objectives.
• General data mapping of ANSI X12 files, including coding, translation, development, testing and deployment.
• Provides data analysis support for NHP business areas in order to assist with the business areas' information, reporting and application development needs.
• Data analysis entails understanding the flow of data and its interdependency among core modules such as Member Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems and Finance.
• Works with QNXT financial processes (FFS, Capitation, and premium billing), QConnect HIPAA EDI (Electronic Data Interchange) standards, data structures, and data relationships. Identifies and resolves problems related to business processes and applications.
• Tracks and monitors problem tickets to ensure timely resolution.
• Communicates status and escalate issues as needed.
• Coordinates and/or performs change and revision management to ensure inter-operability of systems. Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements.
• Establishes and maintains effective relationships with customers and gains their trust and respect.
• Accountable for delivering high quality work.
• Exercises self-awareness, monitors impact on others, is receptive to and seeks out feedback, and uses self-discipline to adjust to feedback.
• Respects the talent and unique contribution of every individual and treats all people in a fair and equitable manner.

Basic Requirements:

• Bachelor's degree in Computer Science, Electrical Engineering, Information Systems, Information Technology, or a related field, plus 6 years of programming/systems analysis experience.
• Demonstrated experience with the design and development of HealthCare technology solutions.
• Proven in depth understanding of QNXT integrated healthcare system, including finance, enrollment, claims, provider network, and system configuration modules.
• Experience with working on Medicare related systems
• Demonstrated ability to code/troubleshoot in SQL, C#.NET, and Visual Studio and to analyze, troubleshoot, and code specific to an integrated healthcare system and its interface to QNXT.
• Demonstrated understanding and experience with core business rules and workflow functionality for Medicaid health plan.
• Demonstrated ability to develop customized solutions to meet business requirements. Proven strong analytical, programming, and project management skills.
• Proven skills in one or more of the following areas: QNXT, QConnect, CCA, or other Integrated HealthCare Systems.
• Demonstrated team player with effective interpersonal skills.

Mass General Brigham Health Plan is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.