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CareSourceCA

Configuration Architect - GuidingCare

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

AU, CA + 3 more

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Job Summary:

The Clinical Systems Configuration Architect is responsible for all architectural disciplines, decision making, drive communication, and collaboration for the enterprise. This role is also responsible for building and maintaining technology strategy for Operationalizing clinical system configuration at CareSource in accordance with evolving business needs in addition to defining ways of working, inclusive of technology standards and guidelines, etc.

What Configuration Architect should have:

Healthcare domain clinical systems experience with in depth configuration knowledge in Health Edge/Guiding Care application suite.

Essential Functions:

  • Accountable for creating and maintaining the architecture disciplines that will guide the organization's technology decisions. This includes developing a comprehensive understanding of the organization's existing technological environment, identifying areas for improvement, and creating a roadmap for future technological initiatives.
  • Define and communicate clinical systems implementation standards, best practices, and guidelines.
  • Maintain a high level of expertise to guide leaders at CareSource.
  • Work closely with business leaders, technology teams, and other stakeholders to understand their needs and ensure that solutions align with business goals and objectives.
  • Maintain familiarity with a wide range of solutions and approaches clinical systems operationalization and be able to evaluate their suitability for the organization. Must be able to recommend appropriate solutions that meet business needs and align with the overall Health Edge Systems Configuration strategy.
  • Develop policies, standards and guidelines that direct the selection, development, implementation, and use of platforms within the enterprise.
  • Provide guidance, training, and mentorship to other team members in Configuration and leaders throughout our department.
  • Maintain a current understanding of modern practices and Software’s.
  • Establish and maintain professional working relationships between the teams and their customers and constituents.
  • Act as a liaison between corporate business areas and collaborate with appropriate business areas to implement proposed solutions and manage programs to evaluate effectiveness and results.
  • Troubleshoot existing clinical configuration to identify errors or deficiencies and develop innovative solutions.
  • Research, review, recommend, communicate, and implement solutions which identify problems/root cause of issues.
  • Evaluate existing Health Edge systems setup/solutions & applications and provide recommendations for improving the application by performing gap analysis and identifying feasible alternative solutions.
  • Provide technical support in analyzing content of clinical configuration in GC application patches, upgrades, and fixes to the production applications.
  • Develop prototypes and options for new system capabilities and work with leadership and business to identify value and opportunities to improve business capabilities.
  • Lead teams in obtaining and analyzing functional and system requirements for complex corporate initiatives and provide expert system consultation, analysis, and recommendations to ensure the development solutions support the business needs.
  • Oversee Health Edge/Guiding Care systems configuration activities performed by other team members, ensuring alignment to the project’s goals, budget and delivery schedule.
  • Work under limited supervision with considerable latitude for initiative and independent judgment.
  • Perform any other job duties as requested.

Education and Experience:

  • Bachelor of Science degree in information technology, business intelligence or related field, or equivalent years of relevant work experience is required.
  • Minimum of seven (7) years of Health Edge/Guiding Care experience in advanced clinical systems configuration, system/business solution analysis and development are required.
  • Minimum of five (5) years of health care domain experience is required.
  • Minimum of two (2) years of experience in project management/leadership role is preferred.
  • TriZetto/Cognizant Facets applications experience is preferred.
  • Implementing LTSS functionality in Health Edge/Guiding Care platform is preferred

Competencies, Knowledge, and Skills:

  • Strong interpersonal skills include excellent written and verbal communication skills; listening and critical thinking; presentation and facilitation skills.
  • Ability to establish effective working relationships with stake holds at all different levels within operations organization.
  • Expert knowledge in Health Edge/Guiding Care applications required.
  • Expert knowledge of Health Edge/Guiding Care data models, APIs, Real Time integration and proven understanding of database relationships required.
  • Ability to facilitate and lead Health Edge/Guiding Care solution design architectures.
  • Knowledge in creating and maintaining road maps for clinical systems functional area.
  • Solid understanding of Managed Care Organization business workflow Excellent communication, presentation, and written skills
  • Advanced computer skills with Microsoft Word, Excel, Access, Visio, and Facets applications
  • Knowledge of Business Intelligence tools and methodologies
  • Excellent understanding of industry standards and technology trends
  • Strong analytical, decision making, and problem-solving skills.
  • Ability to develop, prioritize and accomplish goals.
  • Ability to work independently and within a team environment.

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time.
  • There may be minimal travel to attend vendor product conferences and QBRs

Compensation Range:

$94,100.00 - $164,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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United States +/- 0 hours, and 4 other timezones

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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