Payer Systems & Integration Architect
AI summary of the role
MCG seeks a principal-level subject matter expert to lead payer-side workflow and integration strategy across customer implementations.
What you’ll do
- Serve as MCG’s principal SME and escalation authority for payer workflows, interoperability, integration architecture, and healthcare data flows
- Lead complex workflow discovery and implementation advisory engagements to define integration strategies and guide solution design in payer environments
- Establish and evolve scalable implementation frameworks, standards, reusable assets, and best practices for payer integration engagements
- Partner cross-functionally with Product, Engineering, Implementation, Sales, and customers to align solution design and integration strategy
What you’ll bring
- Bachelor’s degree in Healthcare Administration, Information Systems, Computer Science, Business, or equivalent experience
- At least 8 years of experience with health plan (payer) systems, workflows, operations, and healthcare integrations
- Demonstrated expertise with healthcare interoperability standards including APIs, HL7, FHIR, or related standards
- Proven ability to navigate highly complex or ambiguous payer operational and integration environments
Technologies
HL7 · FHIR · APIs · X12 · HL7 Da Vinci · interoperability · utilization management · prior authorization
About MCG Health
Develops physician-authored evidence-based care guidelines plus software (Indicia, Cite, CareWebQI) that health plans, hospitals, and government agencies use to determine medical necessity and manage utilization.
Acquired · 500–1000 people
Source and classification
Deployment strategy · Evidence for this classification:
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 reduceHow jobs are selected
Employer postings · Data from · Sources