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