Data Architect – PBM Data Modernization

KData Inc.; United States; Remote; USD 140,000 - 190,000; Full time

Job summary

KData Inc. in the United States seeks a Data Architect to lead data modeling and source-to-target mapping for a PBM modernization on Google Cloud.

You will migrate legacy claims and eligibility data and Cognos reporting into a new BigQuery-based data warehouse, aligning with Medicaid reporting requirements for MVP and beyond. You will define semantic and logical data models, own end-to-end mappings, reverse-engineer Cognos assets, set standards, mentor analysts, and work with data engineers on

Qualifications

• 10+ years in data architecture or data modeling, with at least 3 years in PBM, pharmacy, or health plan data.
• Hands-on experience with NCPDP claim standards, Medicaid and managed care reporting, and legacy migration programs.
• Strong skills in dimensional and semantic modeling, plus advanced SQL.
• Experience with IBM Cognos Analytics / Cognos Explorer, including Framework Manager packages, report specifications, and migrating Cognos reporting to a modern BI platform.
• Hands-on experience with Google Cloud data services: BigQuery for warehouse design (partitioning, clustering, authorized views); Dataflow and Dataproc for transformation; Cloud Composer for orchestration; Dataform or dbt for SQL-based transformations.
• Familiarity with Dataplex and Data Catalog for metadata, lineage, and data quality, and with Looker (LookML) for building the semantic layer.
• Proven experience leading analyst teams and running mapping governance.
• Working knowledge of HIPAA, CMS regulations, and state-level Medicaid compliance, along with GCP security controls (IAM, VPC Service Controls, CMEK).
• Location & Work Authorization: Must currently reside in the United States and hold valid US work authorization without sponsorship.

Responsibilities

• Define the semantic and logical data models for MVP and future-state reporting, covering pharmacy claims, member eligibility, prescriber, pharmacy network, formulary, rebates, and pricing domains.
• Own mapping execution end to end. Define source-to-target mappings, transformation rules, and business logic from legacy structures to the new warehouse.
• Inventory and analyze legacy IBM Cognos reports, packages, and Framework Manager models; reverse-engineer embedded logic and rationalize reports for redesign.
• Set mapping standards, templates, naming conventions, and documentation practices; direct the Data and Systems Analysts and review their work.
• Lead gap analysis and drive each gap to a decision with stakeholders.
• Translate state Medicaid reporting requirements into data model and mapping specifications.
• Define data quality rules, reconciliation checkpoints, and lineage for audit-ready results.
• Work with data engineers on ingestion and transformation design on GCP, and use Vertex AI and Gemini to speed up mapping and documentation.

Skills

Data architecture

Data modeling

Dimensional modeling

Semantic modeling

SQL

Leadership

Stakeholder management

Gap analysis

Data quality

Data lineage

Tools

Cognos Analytics

BigQuery

Dataflow

Dataproc

Cloud Composer

Dataform

dbt

Looker LookML

Data Catalog

Dataplex

Vertex AI

Gemini

Job description

Location: Remote (US Only) Industry: Pharmacy Benefit Management (PBM) Platform: Google Cloud Platform

Role Overview

We're looking for a Data Architect to lead data modeling and source-to-target mapping for a Pharmacy Benefit Manager (PBM) modernization program on Google Cloud. The role covers migrating legacy claims and eligibility data, and the IBM Cognos reporting built on it, into a new BigQuery-based enterprise data warehouse. It also ensures the future-state platform meets state-specific Medicaid reporting requirements, starting with the MVP.

Key Responsibilities

• Define the semantic and logical data models for MVP and future-state reporting, covering pharmacy claims, member eligibility, prescriber, pharmacy network, formulary, rebates, and pricing domains.
• Own mapping execution end to end. Define source-to-target mappings, transformation rules, and business logic from legacy structures to the new warehouse.
• Inventory and analyze legacy IBM Cognos (Cognos Explorer / Cognos Analytics) reports, packages, and Framework Manager models. Reverse-engineer embedded business logic and calculations, and rationalize reports for redesign on the future-state platform.
• Set mapping standards, templates, naming conventions, and documentation practices. Direct the Data and Systems Analysts and review their work for quality and consistency.
• Lead gap analysis and drive each gap to a decision (build, defer, workaround, or descope) with business, compliance, and technical stakeholders.
• Translate state Medicaid reporting requirements (encounter data submissions, MCO/PBM transparency reports, spread pricing and pass-through disclosures, T-MSIS-aligned extracts) into data model and mapping specifications.
• Define data quality rules, reconciliation checkpoints, and lineage so legacy-to-target results, including Cognos report outputs, are traceable and audit-ready.
• Work with data engineers on ingestion and transformation design on GCP, and use Vertex AI and Gemini to speed up mapping, profiling, and documentation.

Requirements

Qualifications

• 10+ years in data architecture or data modeling, with at least 3 years in PBM, pharmacy, or health plan data.
• Hands-on experience with NCPDP claim standards, Medicaid and managed care reporting, and legacy migration programs.
• Strong skills in dimensional and semantic modeling, plus advanced SQL.
• Experience with IBM Cognos Analytics / Cognos Explorer, including Framework Manager packages, report specifications, and migrating Cognos reporting to a modern BI platform.
• Hands‑on experience with Google Cloud data services:
  • BigQuery for warehouse design, including partitioning, clustering, and authorized views
  • Dataflow and Dataproc for transformation pipelines
  • Cloud Composer (Airflow) for orchestration
  • Dataform or dbt for SQL-based transformations
• Familiarity with Dataplex and Data Catalog for metadata, lineage, and data quality, and with Looker (LookML) for building the semantic layer.
• Proven experience leading analyst teams and running mapping governance.
• Working knowledge of HIPAA, CMS regulations, and state-level Medicaid compliance, along with GCP security controls (IAM, VPC Service Controls, CMEK).
• Location & Work Authorization: Must currently reside in the United States and hold valid US work authorization without sponsorship.

Nice to Have

• Exposure to Vertex AI or Gemini in BigQuery for AI-assisted mapping, profiling, and documentation.
• Google Cloud Professional Data Engineer or Professional Cloud Architect certification.