Hiring: Lead Enterprise Architect (FEP Medicare Advantage) Company: Blue Cross Blue Shield Association Location: Chicago, IL Job Posted Time: 2026-09-15 12:37:42 Target Skills & Keywords : Business Analysis, Enterprise Architecture, Medicare, Prior Authorization, Project Management, Systems Design About the job Experience: •Required: 10+ Years IT or software development work experience including enterprise architecture, software and system architecture, business analysis and business process architecture, application system design and implementation, technical team leadership •Required: Demonstrated experience defining multi-year MA architectural roadmaps that align with CMS regulatory cycles (e.g., AEP readiness, bid submission, audit/compliance timing) and dual CMS/OPM oversight models where applicable. •Required: Demonstrated experience applying an AI-first approach to architecture and solution design, including evaluating and embedding AI/ML and generative AI capabilities into reference architectures and technology roadmaps to drive efficiency, innovation, and business value. •Preferred: Demonstrated experience architecting solutions within the Federal Employee Program (FEP) ecosystem, including Office of Personnel Management (OPM) oversight requirements distinct from CMS. Required Skills: •Demonstrated capacity to perform cost benefit analysis, business case development, and financial justification •Excellent presentation and communication skills •Understands and consistently applies the attributes and processes of current application development methodologies •Strong research skills in emerging technologies and possible application to the business •Demonstrated capacity to maintain key relationships to achieve business objectives •Solid functional working knowledge of Medicare Advantage data exchange standards and core platforms (e.g., TriZetto Facets or comparable administration systems, ADT/clinical data exchange, prior authorization, payment integrity, and real-time claims adjudication architectures). •Demonstrated capacity to architect for emerging MA capability areas (e.g., intelligent provider navigation, real-time prior authorization, AI-driven Stars/quality improvement) and incorporate them into multi-year technology roadmaps. •Demonstrated capacity to evaluate emerging AI tools and platforms for architectural fit, scalability, and responsible AI considerations (e.g., data privacy, model governance, explainability) within a regulated healthcare environment. Qualifications: •Required Bachelor's Degree in Computer Science or Engineering, Information Systems, Business Administration, Engineering or Science field, or equivalent work experience in similar work environment. •Preferred Master's Degree in Computer Science, Information Systems, Business Administration, or Management •In-depth knowledge of state-of-the-art programming languages and object oriented approaches in designing, coding, testing and debugging programs •Extensive use of Project Management methodologies •Expert level understanding of the health insurance industry preferred •Advanced analytical and conceptual skills •Demonstrated capacity to create original concepts/theories for various projects Compensation: •Expert level understanding of the health insurance industry preferred Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!