Payer Systems & Integration Architect

Responsibilities

• Serve as the principal subject matter expert for payer workflows, interoperability, and integration architecture
• Lead complex workflow discovery and implementation advisory engagements for diverse payer environments
• Advise implementation teams on integrating MCG solutions into complex payer technical ecosystems
• Identify and resolve complex interoperability and integration risks and dependencies
• Partner cross-functionally with Product, Engineering, and Sales to align solution design and execution
• Establish scalable implementation frameworks, standards, and reusable assets
• Provide functional leadership and mentorship to implementation team members
• Deliver customer-driven feedback to Product and Engineering regarding workflow gaps and enhancement opportunities

Requirements

• Bachelor’s degree in Healthcare Administration, Information Systems, Computer Science, Business, or related field
• At least 8 years of experience with health plan (payer) systems, workflows, and healthcare integrations
• Demonstrated experience leading complex healthcare implementations or workflow transformations
• Expertise in healthcare interoperability, APIs, HL7, FHIR, or related standards
• Proven ability to translate technical and business requirements into scalable implementation guidance
• Experience working cross-functionally in matrixed environments
• Strong communication skills for engaging both technical and non-technical audiences

Preferred Qualifications

• Knowledge of HL7 Da Vinci, FHIR, and X12 standards
• Knowledge of utilization management and prior authorization workflows
• Knowledge of provider system workflows and payer-provider interoperability
• Experience developing implementation standards and reusable methodologies
• Experience supporting organizational change or process improvement initiatives

About the Company

MCG is a mission-driven healthcare organization that leads the community to deliver patient-focused care through evidence-based content and innovative products.