Solution Architect

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