Sr. Business Architect

Qualitest Group

Chicago

JOB DETAILS
JOB TYPE
Employee
LOCATION
Chicago
POSTED
5 days ago

Are you interested in working with the World’s leading AI-powered Quality Engineering Company? Ready to advance your career, team up with global thought leaders across industries and make a difference every day? Join us at Qualitest!

We are looking for a Business Architect to join our growing team in United States! 
Required Skills & Experience:

  • 10+ years of experience as a Business Analyst or similar role, ideally in digital transformation and healthcare payer domains.
  • Strong expertise of healthcare payer concepts including claims lifecycle, fee schedules, contracts, and pricing adjudication.
  • Hands-on experience working with pricer tools and claims pricing logic.
  • Knowledge of 837 claim transaction sets and EDI standards.
  • Deep knowledge of healthcare payer systems, preferably with experience in Trizetto Facets or comparable platforms.
  • Strong technical background with proficiency in SQL, data modeling (star/snowflake schema, SCDs), and software development lifecycle concepts.
  • Experience with integration technologies such as REST APIs, SOAP, and SOA architecture.
  • Familiarity with software frameworks and tools such as C#, .NET, PL/SQL, and database platforms like Oracle and MS SQL Server.
  • Demonstrated ability to lead ambiguity reviews, transition management, and change initiatives in complex program environments.
  • Excellent communication, stakeholder management, and documentation skills.
  • Experience managing or collaborating with offshore teams is a plus.
  •  

Key Responsibilities:

  • Lead large-scale digital transformation programs, including legacy system replatforming, data normalization, and modernization efforts.
  • Elicit, analyze, and translate business requirements into clear technical specifications and process flows, leveraging expertise in healthcare payer domain (claims, membership, billing, provider modules).
  • Work with pricer tools and expertise in pricing of claims, fee schedules, contracts, and payer concepts to ensure accurate claims adjudication and financial modeling.
  • Leverage knowledge of 837 claim transaction sets and Electronic Data Interchange (EDI) standards to support claims processing and integration.
  • Collaborate closely with cross-functional teams including architects, developers, QA, and offshore teams to ensure high-quality, timely delivery.
  • Drive requirements transformation, ambiguity resolution, and change management to support agile and waterfall SDLC methodologies.
  • Define and document reference architectures, data flows, and process models to facilitate shared expertise and compliance.
  • Support solution design and integration initiatives using APIs, SOA, RESTful/SOAP web services, and enterprise system extensions.
  • Utilize strong data modeling, SQL, and ETL skills to support data extraction, transformation, and reporting activities across heterogeneous data sources.
  • Partner with technical leads and project managers to monitor program health, risks, and deliverables ensuring alignment with business objectives.
  • Champion best practices in business assurance, quality management, and automation strategies.

 

Preferred Qualifications:

  • Bachelor’s degree in Computer Science, Information Systems, Healthcare IT, or related field.
  • Certification in Business Analysis (CBAP, PMI-PBA) or Agile methodologies.
  • Prior experience in large-scale legacy system replatforming or data modernization programs.

 

Are you interested in working with the World’s leading AI-powered Quality Engineering Company? Ready to advance your career, team up with global thought leaders across industries and make a difference every day? Join us at Qualitest!

We are looking for a Business Architect to join our growing team in United States! 
Required Skills & Experience:

  • 10+ years of experience as a Business Analyst or similar role, ideally in digital transformation and healthcare payer domains.
  • Strong expertise of healthcare payer concepts including claims lifecycle, fee schedules, contracts, and pricing adjudication.
  • Hands-on experience working with pricer tools and claims pricing logic.
  • Knowledge of 837 claim transaction sets and EDI standards.
  • Deep knowledge of healthcare payer systems, preferably with experience in Trizetto Facets or comparable platforms.
  • Strong technical background with proficiency in SQL, data modeling (star/snowflake schema, SCDs), and software development lifecycle concepts.
  • Experience with integration technologies such as REST APIs, SOAP, and SOA architecture.
  • Familiarity with software frameworks and tools such as C#, .NET, PL/SQL, and database platforms like Oracle and MS SQL Server.
  • Demonstrated ability to lead ambiguity reviews, transition management, and change initiatives in complex program environments.
  • Excellent communication, stakeholder management, and documentation skills.
  • Experience managing or collaborating with offshore teams is a plus.
  •  

Key Responsibilities:

  • Lead large-scale digital transformation programs, including legacy system replatforming, data normalization, and modernization efforts.
  • Elicit, analyze, and translate business requirements into clear technical specifications and process flows, leveraging expertise in healthcare payer domain (claims, membership, billing, provider modules).
  • Work with pricer tools and expertise in pricing of claims, fee schedules, contracts, and payer concepts to ensure accurate claims adjudication and financial modeling.
  • Leverage knowledge of 837 claim transaction sets and Electronic Data Interchange (EDI) standards to support claims processing and integration.
  • Collaborate closely with cross-functional teams including architects, developers, QA, and offshore teams to ensure high-quality, timely delivery.
  • Drive requirements transformation, ambiguity resolution, and change management to support agile and waterfall SDLC methodologies.
  • Define and document reference architectures, data flows, and process models to facilitate shared expertise and compliance.
  • Support solution design and integration initiatives using APIs, SOA, RESTful/SOAP web services, and enterprise system extensions.
  • Utilize strong data modeling, SQL, and ETL skills to support data extraction, transformation, and reporting activities across heterogeneous data sources.
  • Partner with technical leads and project managers to monitor program health, risks, and deliverables ensuring alignment with business objectives.
  • Champion best practices in business assurance, quality management, and automation strategies.

 

Preferred Qualifications:

  • Bachelor’s degree in Computer Science, Information Systems, Healthcare IT, or related field.
  • Certification in Business Analysis (CBAP, PMI-PBA) or Agile methodologies.
  • Prior experience in large-scale legacy system replatforming or data modernization programs.

 

About the Company

Q

Qualitest Group

QualiTest is the world’s second largest pure play software testing and QA company. Testing and QA is all that we do!

We design and deliver contextualized solutions that leverage deep industry-specific understanding with technology-specific competencies and unique testing-focused assets.

QualiTest delivers results by combining customer-centric business models, critical thinking and the ability to gain a profound comprehension of customers’ goals and challenges.

COMPANY SIZE
1,500 to 1,999 employees
INDUSTRY
Computer/IT Services
FOUNDED
1997
WEBSITE
https://www.qualitestgroup.com/