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Job description
Enterprise Architect with Medicare Medicaid Duals experience
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Enterprise Architect with Medicare Medicaid Duals experience
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Join to apply for the Enterprise Architect with Medicare Medicaid Duals experience role at Tata Consultancy Services
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Lead the architecture and integration of FIDE plan systems, including claims processing, eligibility, provider management, and reporting platforms.
Comprehend end-to-end workflows for dual-eligible member journeys, ensuring compliance with CMS and state requirements.
Oversee system enhancements for rate updates, retroactive claims, and encounter data submissions.
Collaborate with cross-functional teams to identify pain points and recommend process and technology improvements.
Ensure auditability, data integrity, and regulatory compliance across all FIDE-related systems.
Develop and maintain architecture documentation, data flow diagrams, and integration specifications.
Support implementation of new markets and retrofit best practices into existing FIDE programs.
Lead the architecture and integration of FIDE plan systems, including claims processing, eligibility, provider management, and reporting platforms.
Comprehend end-to-end workflows for dual-eligible member journeys, ensuring compliance with CMS and state requirements.
Oversee system enhancements for rate updates, retroactive claims, and encounter data submissions.
Collaborate with cross-functional teams to identify pain points and recommend process and technology improvements.
Ensure auditability, data integrity, and regulatory compliance across all FIDE-related systems.
Develop and maintain architecture documentation, data flow diagrams, and integration specifications.
Support implementation of new markets and retrofit best practices into existing FIDE programs.
Must Have Technical/Functional Skills
Lead the architecture and integration of FIDE plan systems, including claims processing, eligibility, provider management, and reporting platforms.
Comprehend end-to-end workflows for dual-eligible member journeys, ensuring compliance with CMS and state requirements.
Oversee system enhancements for rate updates, retroactive claims, and encounter data submissions.
Collaborate with cross-functional teams to identify pain points and recommend process and technology improvements.
Ensure auditability, data integrity, and regulatory compliance across all FIDE-related systems.
Develop and maintain architecture documentation, data flow diagrams, and integration specifications.
Support implementation of new markets and retrofit best practices into existing FIDE programs.
Roles & Responsibilities
Lead the architecture and integration of FIDE plan systems, including claims processing, eligibility, provider management, and reporting platforms.
Comprehend end-to-end workflows for dual-eligible member journeys, ensuring compliance with CMS and state requirements.
Oversee system enhancements for rate updates, retroactive claims, and encounter data submissions.
Collaborate with cross-functional teams to identify pain points and recommend process and technology improvements.
Ensure auditability, data integrity, and regulatory compliance across all FIDE-related systems.
Develop and maintain architecture documentation, data flow diagrams, and integration specifications.
Support implementation of new markets and retrofit best practices into existing FIDE programs.
Qualifications
Bachelor’s degree in Computer Science, Information Systems, or related field (Master’s preferred).
8+ years of experience in healthcare IT, with at least 1 year in Medicaid/Medicare duals or FIDE programs.
Strong knowledge of claims, eligibility, provider, and compliance systems.
Experience with system integration, data management, and regulatory reporting.
Generic Managerial Skills, If any
Collaborate with Project stakeholders and Drive the team to complete the deliverables
Proven success working in large Medicare FDE programs
Expertise in solving complex business functional issues, and manage the stakeholders.
Team management
Salary Range: $120,000 - $160,000 a Year
TCS Employee Benefits Summary
Discretionary Annual Incentive.
Comprehensive Medical Coverage: Medica l & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
Family Support: Maternal & Parental Leaves.
Insurance Options: Auto & Home Insurance, Identity Theft Protection.
Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
Time Off: Vacation, Time Off, Sick Leave & Holidays.
Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Seniority level
Seniority level
Mid-Senior level
Employment type
Employment type
Full-time
Job function
Job function
Information Technology
Industries
IT Services and IT Consulting
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Worksite address
louisville, KY, 40201, US
Who can apply
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