Work with business SMEs to understand and reengineer functionalities such as claims intake, validation, adjudication, auto adjudication, claims edits, benefit and eligibility validation, provider/member information, pricing/payment workflows, claim exceptions, routing, pend/review workflows, and reprocessing. Define and implement enterprise class structure, application and ruleset architecture, case types and stages, flows and flow actions, data pages and data transforms, activities, decision tables and decision trees, declarative rules, validation rules, SLAs, queue processors, and security.