Payer Systems & Integration Architect

Requirements

• Bachelor's degree in Healthcare Administration, Infor

Benefits

Additional Information

At MCG, we lead the healthcare community to deliver patient-focused care. We have a mission-driven team of talented physicians and technical experts developing our evidence-based content and innovating our products to accelerate improvements in healthcare. If you are driven to enhance the US healthcare system, MCG is eager to have you join our team. We cultivate a work environment that nurtures personal and professional growth, and this is a thrilling time to become a part of our organization. With dynamic roles that offer meaningful impact, you'll be able to fully realize your potential. Plus, you'll enjoy world-class benefits and the security, stability, and resources of our parent company, Hearst, with over 100 years of experience. The Payer Systems & Integration Architect serves as MCG's principal subject matter expert in payer-side healthcare workflows, system integrations, and data flows, providing strategic advisory guidance during customer implementations and complex solution design efforts. This role partners closely with Implementation, Product, Engineering, and customer stakeholders to address highly complex workflow and integration challenges, define scalable approaches, and guide implementation strategies within diverse payer environments. Operating with a high degree of independence, this individual applies deep expertise in health plan operations, interoperability, and system interactions to identify risks, resolve ambiguity, and improve implementation effectiveness across customer engagements. The role is also responsible for helping establish and mature this emerging capability at MCG by developing repeatable frameworks, standards, best practices, and reusable implementation approaches that strengthen organizational scalability and reduce dependency on limited subject matter expertise. You Will: - Serve as MCG's principal subject matter expert and escalation authority for payer workflows, interoperability, integration architecture, and healthcare data flows across customer implementations and internal initiatives. - Lead complex workflow discovery and implementation advisory engagements to define integration strategies, clarify operational requirements, and guide solution design within diverse payer environments. - Advise implementation teams and customers on how MCG solutions integrate into complex payer operational and technical ecosystems, including utilization management workflows such as prior authorization . - Identify and resolve highly complex workflow, interoperability, and integration risks, gaps, dependencies, and implementation challenges, recommending scalable mitigation strategies and alternative approaches where standard solutions are insufficient. - Partner cross- functionally with Product, Engineering, Implementation, Sales, and customer stakeholders to align solution design, integration strategy, technical dependencies, and implementation execution. - Translate complex operational and technical concepts into clear, actionable guidance for technical teams, business stakeholders, and customers. - Facilitate working sessions with internal teams and customers to align on workflows, integration points, data dependencies, interoperability considerations, and implementation approaches. - Establish and evolve scalable implementation frameworks, standards, reusable assets, workflow models, and best practices that improve consistency, predictability, and organizational capability across payer integration engagements. - Analyze implementation trends and recurring workflow or interoperability challenges to identify opportunities for process improvement, scalability, and operational efficiency. - Provide expert consultation and real-time workflow and integration guidance during customer engagements, reducing dependency on Product and Engineering resources for operational interpretation and implementation support. - Provide functional leadership, mentorship, and subject matter guidance to implementation team members on payer operations, interoperability concepts, integration strategy, and complex issue resolution. - Serve as a senior advisor during customer strategy and pre-implementation discussions to assess feasibility, clarify integration considerations, and align implementation expectations. - Provide customer -driven feedback to Product and Engineerin g teams r egarding workflow gaps, interoperability chal lenges, implem entation friction points, and enhancement opportunities. - Develop knowledge aids and support cross-functional enablement efforts to strengthen payer workflow a nd integration knowledge across implementation and customer-facing teams. - Use AI-enabled tools and technologies appropriately to improve implementation efficiency, workflow analysis, documentation quality, and knowledge-sharing while ensuring accuracy, security, and alignment with organizational standards.

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