Enterprise Architect (Healthcare Payor)

Enterprise Architect

We are seeking experienced Enterprise Architects to drive our transition from outsourced IT solutions to a scalable and integrated in-house architecture. This role is critical in designing and implementing enterprise-level strategies across Medicare Advantage, Medicaid, commercial, and self-funded insurance products. The ideal candidate will have a deep understanding of integration frameworks, health rules platforms, and the complexities of the payor space.

Key Responsibilities

• Design and implement enterprise architecture strategies for integrating platforms and migrating legacy systems.
• Transition point-to-point integrations to an abstracted, reusable integration framework.
• Collaborate with internal and external stakeholders to align architecture with business needs for eligibility, billing, and claims systems.
• Provide insights on TPA integrations and oversee the migration of groups to in-house solutions.
• Develop scalable solutions for fully funded and self-funded insurance models with a strong focus on compliance, scalability, and operational efficiency.
• Lead architecture reviews, ensuring alignment with strategic goals.
• Mentor and guide technical teams to execute architecture designs effectively.

• Bachelor's degree in Computer Science, Information Systems, or related field; Master's preferred.
• 8+ years of experience in enterprise architecture, with a focus on the healthcare payor industry.
• Expertise in integration technologies, API frameworks, and middleware solutions.
• Strong knowledge of Medicare Advantage, Medicaid, and commercial insurance products.
• Experience with healthcare IT platforms and systems integration.
• Proven track record of migrating outsourced solutions to in-house environments.
• Excellent communication and stakeholder management skills.

• Familiarity with TPAs and transitioning outsourced work to in-house teams.
• Knowledge of vendor management and transitioning large-scale systems.
• Experience working with remote and distributed teams.

Location

Remote

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