Senior Health Plan Implementation Architect

Francisco Partners; United States; Hybrid; USD 113,000 - 165,000; Full time

Job summary

Veradigm is seeking an Implementation Architect to lead complex client deployments across Payer Analytics and Risk Adjustment suites, translating health plan and provider requirements into scalable designs and guiding cross-functional teams.

You will own data integration, mappings, validation, and analytics engine configurations, with expertise in CMS-HCC, HHS-HCC, HL7 FHIR, EDI, and eChart. Travel up to 50% may be required.

Qualifications

• Bachelor's degree or equivalent technical/business experience.
• 10+ years relevant work experience; expert level preferred for internal candidates.
• Deep functional knowledge of CMS-HCC, HHS-HCC, and quality analytics requirements.
• Experience with Medicaid, Medicare, and ACA marketplace lines and cycles.
• Advanced knowledge of HL7 FHIR, CCDA, EDI, and data exchange standards.
• Proven ability to architect complex scalable solutions across multiple engagements.
• Advanced SQL and database expertise for data validation and analytics.
• Experience with claims, eligibility, provider, encounter data in payer analytics.
• Experience designing ETL/ELT processes and healthcare data pipelines.
• Excellent client-facing communication and consulting skills.
• Demonstrated project and program leadership; mentoring capabilities.
• Ability to operate independently in ambiguous, high-complexity situations.

Responsibilities

• Lead end-to-end solution architecture and technical design for enterprise-level implementations of Veradigm Payer Analytics and Risk Adjustment solutions.
• Partner with health plan and at-risk provider clients to translate business and regulatory requirements into detailed technical plans.
• Advise clients on CMS-HCC, state Medicaid models, and ACA HHS-HCC submissions and timelines.
• Design data integration strategies using HL7 FHIR, CCDA, EDI and eChart integration to ensure timely data exchange.
• Architect data onboarding strategies for claims, eligibility, provider, and encounter data into Veradigm platforms.
• Define data mappings and transformation approaches across client and third-party sources for scalable implementations.
• Own data quality frameworks, validation, reconciliation, and exception handling.
• Lead root cause analysis and remediation for data issues during onboarding and validation.
• Architect configuration of analytics engines, coding workflows, and provider engagement solutions.
• Provide roadmaps, risk assessments, and mitigation plans for go-lives; mentor junior staff.

Skills

Bachelor's degree or equivalent

10+ years experience

Healthcare risk adjustment

Quality analytics

CMS-HCC / HHS-HCC

Medicaid / Medicare / ACA

HL7 FHIR / CCDA / EDI

SQL & database

ETL/ELT design

Client-facing communication

Leadership & mentoring

Education

Bachelor's degree or equivalent

Tools

Azure Data Factory

Azure SQL

Azure Synapse

Azure Data Lake

Databricks

Job description

Veradigm is seeking an Implementation Architect to lead complex client deployments across Payer Analytics and Risk Adjustment suites, translating health plan and provider requirements into scalable designs and guiding cross-functional teams.

You will own data integration, mappings, validation, and analytics engine configurations, with expertise in CMS-HCC, HHS-HCC, HL7 FHIR, EDI, and eChart. Travel up to 50% may be required.