Integration and Data Exchange Architect
Employment Type: Full-Time
AllyAlign Health (www.allyalign.com) is a rapidly growing organization focused on revolutionizing the long-term healthcare ecosystem for the benefit of our members, provider and payer partners. Our unique approach to managing care delivery and proactively partnering with healthcare providers has enabled us to achieve industry leading health outcomes for our members.AllyAlign Health has partnered with several Nursing Home companies to form Institutional Special Needs Plans (I-SNPS), which are a form of Medicare Advantage Plans.
In this model, AllyAlign is responsible for administering the health plans, providing shared services such as member enrollment, call center, claims processing, authorization processing, financial services, compliance services and grievance and appeals administration. AllyAlign has grown very aggressively and is working to expand our operational capacity and capability.
We arepreparingfor the next exciting phase of our growthwithexpansionacross multiplenew states. To enable us to scale and continue our transformation of long-term healthcare delivery,we havemany new project initiatives and capabilities that need to be delivered. A key part of our technology strategy is focused on how we leverage integration between clinical and business administration systems to drive better health and business outcomes for our members and healthcare providers respectively I'm sure there are better ways to say this!
AllyAlign Health is now looking to for an Integration and Data Exchange Architect to help create the vision for this strategy and implement the practical steps required to delivery on it.
The Integration and Data Exchange Architect requires deep technical expertise, combined with excellent planning, coordination and communication skills. The core responsibility of this role is the design, implementation, development, integration, enhancement and optimization of flows (data and services) between AAH systems and partner systems from vendors/suppliers or subscribers/constituents to enable or complete a process. This role will be the system integration and data exchange subject matter expert and has a broad understanding of multiple IT disciplines (application, infrastructure, data/information, security, testing, etc.) and EDI programming practices, standards and conventions.
They must be pro-active and create a system integration strategy and roadmap that anticipates future customer, industry and information technology trends. The successful candidate requires technical knowledge and skills that are broad and deep, covering various hardware, software, and platforms.
A strong understanding of EDI programming practices, standards and conventions.
- Responsible for the setup of all new EDI file feeds, monitoring and tracking all scheduled EDI file feeds
- Responsible for notifying the appropriate vendors when the files / integrations are not received or if corrections/updates need to be made to the extracts.
- Responsible for identifying ways to improve the EDI process to more efficiently manage all facets of the file feed integrations to capture all necessary data.
- Make sure that EDI Production systems are running fine and escalating the issue as and when needed.
- Knowledge of various integration design patterns and how best to leverage them
- A strong understanding of EDI programming practices, standards and conventions.
- Strong facilitation skills to engage subject matter experts to define platform requirements and conduct detailed design reviews with project teams.
- Deep understanding of modern technologies (e.g. APIs, FHIR, HL7, service orchestration, event driven data streams, secure messaging, etc.)
- Support the EDI Operations by resubmitting files, explaining X12 compliance errors, and explaining the logic used to format fields in the translator maps. Investigate questions from various users.
- Maintain compliance with changing standards and changing trading partners/carriers requirements.
- Manage and ensure standards across all Data Exchange activities and lead team to effective and quality project deliverables within the established timeframe.
- Working knowledge of Health information exchange platforms/Partners such as Redox
- Analyze, evaluate and provide solutions for Integration projects and platforms for consolidation, optimization and operational efficiency
- Setup, update, modify new and existing EDI file feeds
- Identifying and helping to remediate and adapt inconsistencies between current state application architecture and function, and Architectural Definition and Direction
- Maintain thorough knowledge/expertise of workflows, policies, procedures and systems related to applications with the assigned business domain
- Decompose the technical architecture into more granular elaboration, design and implementation work items with estimates, collaborating with Project Management on appropriate scheduling within the plan
- performs technical planning, architecture development and modification of specifications.
- Develops specifications for new products/services, applications and service offerings.
- Assesses the compatibility and integration of products/services proposed as standards in order to ensure an integrated architecture across interdependent applications.
- Begins to influence department's strategy.
- Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
- Exercises considerable latitude in determining objectives and approaches to assignments.
Knowledge & Skills Required:
- Master's degree, preferred in Computer Science; or relevant work experience
- Minimum of 10 years of system/Data Integration development experience with progressive responsibilities
- 2+ years of experience with 5010 X12 Healthcare Electronic Data Interchange (EDI) mapping, and EDI analysis.
- 5+ years of experience in developing architecture road maps, reference architectures, and evangelizing adoption of architecture principles in the design and delivery of technology solutions
- Experience with cloud native architectures, micro services, enterprise integration platforms, messaging infrastructures, and event driven architectures
- Experience with custom application development and COTS software, CRM platforms, caching, and database technologies methods
- Experience with HL7 engine, X12, EMRs and HISP
- Has knowledge of the healthcare landscape with specific understanding of CMS, Medicare/Medicaid, and claims adjudication.
- Understanding of the long-term care and provider-sponsored plans industries
- Ability and willingness to learn new software technologies and adapt to change
- Market competitive salary
- Flexible PTO
- 9 Paid Holidays per Year (7 fixed and 2 floating)
- Medical Insurance
- Dental Insurance benefits
- Vision Insurance benefits
- Health Savings Account contributions if you elect to participate in our Medical Insurance plan
- Long-Term Disability / Short-Term Disability and Life Insurance
- 401K Plan
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