Business Architect (Core Claims) – Medicaid / Medicare (Remote) | CNSI



CNSI is seeking an experienced Principal Business Solution Architect with specific knowledge around Claims Pricing and Edits. This person will provide end-to-end solution architecture for the new onboarding programs during fit-gap and solutioning phases. This role is a member of the Operations Team and reports directly to the Vice President of Design CoE. Working remotely within the United States is acceptable for this position.

Job Responsibilities

  • Provide domain expertise in business solution architecture field, emerging trends, and industry practice.
  • Act as the requirements subject matter expert and support requirements change management.
  • Propose end-to-end functional and technical solutions for complex business requirements.
  • Create conceptual design and write technical specifications for business requirements.
  • Frequently apply in-depth Business Architecture knowledge to review and analyze systems problems and identify solutions.
  • Develop uses cases, workflow diagrams, and conduct gap analysis to create and modify requirements documents and design specifications.
  • Research and evaluate industry trends and technologies for solving complex technical problems.

Experience/Preferred Skills Required

  • Master’s Degree or Bachelor’s Degree with a minimum of 15 years of business solution or analysis or related experience.
  • 5+ years of technical leadership experience at large complex organizations, including leading centralized or matrixed teams.
  • 8+ years of Lead Business Solution and/or Analyst experience on large complex projects.
  • Medicaid / Medicare (healthcare) background and a high-level of technical and database knowledge.
  • Experience facilitating and running JAD requirements design sessions, etc.
  • Computer Science Engineering Business Administration or a closely related field, is preferred.
  • Experience with Systems Development Life Cycle (SDLC)Experience in healthcare industry, is preferred.
  • Core Claims and/or Provider Management and Enrollment System experience, is preferred.
  • Excellent requirements elicitation and validation skills, is preferred.
  • Management & Leadership skills with a high-level of technical and database knowledge, is preferred.

About Us

At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We’re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.

Innovation and commitment to our mission are core to our DNA. And through our shared values, we foster an environment of inclusion, empowerment, accountability, and fun! You will be offered a competitive compensation and benefits package.

CNSI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status, genetic status, family responsibilities, protected veteran status or any other status protected by applicable Federal, state, or local law. We are proud of our diversity and encourage all qualified applicants to apply.


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