Job Location & Mode: United States, Remote, Willing to go to client site on a need basis

Role Summary

The Solution Architect for Medicaid programs will lead the design and implementation of large-scale

data transformation, modernization, and data center migration initiatives. This role ensures that

Medicaid systems and data platforms are transformed into scalable, compliant, and cloud-ready

architectures while maintaining regulatory integrity and supporting business continuity.

Key Responsibilities

1. Solution Architecture & Design

Design end-to-end architecture for Medicaid systems covering eligibility, claims, provider, and

pharmacy data.

Develop architecture blueprints for data transformation, modernization, and cloud migration.

Define target state architecture including data lakes, warehouses, and API-driven ecosystems.

2. Data Transformation & Modernization

Lead transformation of legacy Medicaid data into modern platforms.

Define data models aligned with Medicaid Information Technology Architecture (MITA).

Standardize healthcare data using HL7, FHIR, ICD, CPT, and other relevant standards.

Enable advanced analytics, reporting, and interoperability capabilities.

3. Data Center Migration / Cloud Transformation

Plan and execute migration from on-premise data centers to cloud platforms

(Azure/AWS/Google Cloud Platform).

Define migration strategies (rehost, replatform, refactor).

Ensure high availability, disaster recovery, and performance optimization.

Oversee cutover planning, rollback strategies, and transition governance.

4. Medicaid Domain Alignment

Ensure solutions align with Medicaid business processes:

o Eligibility & enrolment

o Claims processing (fee-for-service & managed care)

o Provider management

o Pharmacy & benefits

Ensure compliance with CMS, HIPAA, and state-specific Medicaid regulations.

5. Integration & Interoperability

Architect integrations between Medicaid systems, external partners, and federal/state

exchanges.

Design API frameworks, microservices architecture, and middleware integration.

Enable interoperability with HIEs (Health Information Exchanges).6. Data Governance & Compliance

Establish data governance frameworks including data quality, lineage, and security.

Ensure compliance with HIPAA, CMS guidelines, and data privacy regulations.

Define access controls and audit mechanisms.

7. Technical Leadership

Provide technical leadership across architecture, data, and engineering teams.

Conduct architecture reviews and ensure adherence to standards.

Mentor teams on best practices in cloud, data, and security.

8. Stakeholder Management

Collaborate with business stakeholders, Medicaid SMEs, and government agencies.

Translate business needs into scalable technical solutions.

Present architecture strategies to leadership and clients.

Required Skills & Competencies

Medicaid Domain Expertise

Strong knowledge of:

o Medicaid systems and workflows

o CMS regulations and MITA framework

o Claims adjudication and provider networks

Experience in payer systems or public healthcare programs

Technical Skills

Expertise in:

o Cloud platforms (Azure / AWS / Google Cloud Platform)

o Data platforms (Data Lake, Data Warehouse, Big Data)

o ETL/ELT tools and data pipelines

Strong knowledge of:

o Microservices, APIs, and event-driven architectures

o Databases (SQL, NoSQL)

o DevOps, CI/CD pipelines

o Containerization (Docker, Kubernetes)

Data & Integration

Experience with:

o Healthcare data standards (FHIR, HL7, X12 EDI)

o Data migration and transformation tools

o API gateways and integration platforms

Soft Skills

Excellent communication and stakeholder engagement

Strong analytical and architectural thinking

Ability to lead cross-functional teams

Problem-solving and decision-making under complexity

Qualifications

Bachelor's/Master's degree in Computer Science, Engineering, or related field

10 18 years of IT experience with:

o 5+ years as Solution/Enterprise Architect

o Experience in Medicaid or healthcare payer systems

Certifications (preferred):

o AWS/Azure Solutions Architect

o TOGAF or equivalent

o Healthcare or Data certifications (optional)

Key Deliverables

Architecture blueprints and roadmaps

Data migration and transformation strategy documents

Integration design and API specifications

Cloud migration plans and execution frameworks

Governance and compliance documentation

Success Metrics

Successful migration with minimal downtime

Data accuracy and integrity post-transformation

Compliance adherence (HIPAA, CMS)

Performance and scalability of modernized systems

Stakeholder and client satisfaction

Solution Architect

Key skills

About this role