1 day ago
Chicago, IL, USA or Richardson, TX, USASenior

Base Salary

$93k - $168k/yr

Responsibilities

  • Define and execute application architecture strategies aligned with business objectives and enterprise roadmaps.
  • Design scalable end-to-end enterprise solutions spanning multiple systems, products, and business domains.
  • Guide solution designs and integrate applications, databases, and middleware supporting claims and payment accuracy initiatives.
  • Partner with Product, Business, Clinical, Operations, and Technology teams to deliver payment integrity solutions.
  • Support healthcare payment integrity capabilities including claims editing, coding validation, reimbursement methodologies, provider billing compliance, and claims adjudication workflows.
  • Lead architecture governance, vendor evaluations, and strategic technology roadmap development.
  • Communicate technical direction and align cross-functional stakeholders around a shared architectural vision.

Requirements

  • Bachelor’s degree with 4 years of Information Technology experience, or technical certification and/or college coursework with 6 years of Information Technology experience, or 8 years of Information Technology experience.
  • Experience in application architecture, solution design, or product architecture.
  • Experience with application development platforms, modern programming technologies, cloud computing platforms, and cloud services.
  • Experience with DevOps, CI/CD pipelines, Agile delivery methodologies, enterprise integration technologies, and API-based architecture.
  • Strong analytical, problem-solving, communication, collaboration, and relationship-building skills.
  • Preferred experience with healthcare payer, payment integrity, claims processing, revenue management, or related healthcare domains.
  • Preferred knowledge of payment integrity functions, healthcare data and transaction processing, cloud-native architectures, microservices, APIs, event-driven systems, modern integration frameworks, application security, healthcare compliance, data privacy, and secure design principles.
  • Preferred experience integrating third-party payment integrity solutions and leading architecture governance, vendor evaluations, and technology roadmaps.

Benefits

  • Work-from-home role performed remotely within the continental United States, excluding California, New York, Alaska, and Hawaii.
  • Benefits include health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, and other incentives.
  • Role participates in an annual incentive bonus plan subject to plan terms and conditions.

Categories

Health Care Service Corporation

About Health Care Service Corporation

10,000+ employees

Health Care Service Corporation is a mutual health insurer that operates the Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. It sells medical, pharmacy, dental, life, Medicare, and Medicaid coverage to employers, individuals, and public programs, and provides related health data and pharmacy services. Headquartered in Chicago, it serves nearly 23 million members and generates revenue primarily from insurance premiums and administrative services fees.

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