Job Summary
We are seeking a Business Solution Architect with deep expertise in process reimagination and AI-driven healthcare solutions. This role bridges business strategy, healthcare operations, and advanced AI technologies to redesign end-to-end clinical, operational, and administrative processes.

Key Responsibilities
• Lead process reimagination initiatives across healthcare domains.
• Identify inefficiencies and design future-state AI-enabled workflows.
• Architect end-to-end AI-driven healthcare solutions.
• Ensure regulatory compliance and ethical AI usage.
• Collaborate with clinicians, business leaders, and technology teams.
• Produce enterprise-level business designs and system requirements aligned with product vision.
• Lead teams of Business Analysts and QA professionals for customer engagements.

Required Qualifications
• Bachelor's or Master's degree in a relevant field.
• 10+ years of overall IT experience in Business Analysis within the healthcare domain.
• 5+ years of experience architecting business solutions.
• 8-10+ years of healthcare or digital transformation experience.
• 3+ years of experience with AI-enabled healthcare solutions.
• Deep understanding of health plan domains, including claims, membership, provider networks, utilization management/case management, and payment models.
• Strong understanding of the end-to-end claims cycle across commercial, Medicare, Medicaid, and marketplace lines of business.
• Understanding of how AI can be leveraged to improve healthcare processes and solutions.
• Proven ability to produce enterprise-level business designs and system requirements.
• Strong stakeholder management and communication skills.

Preferred Qualifications
• Experience with EHR systems.
• Knowledge of HL7 and FHIR standards.
• Experience with cloud-based healthcare AI solutions.
• Architecture or healthcare-related certifications.