Senior Payer Analytics Implementation Architect

LE1000 Veradigm LLC; United States; Hybrid; USD 113,000 - 165,000; Full time

Job summary

Veradigm seeks an Implementation Architect to lead end-to-end architectures and technical designs for Payer Analytics and Risk Adjustment implementations across Medicaid, Medicare, and ACA lines.

You will partner with clients, guide cross-functional delivery teams, ensure regulatory compliance, and architect scalable data integration solutions using HL7 FHIR, CCDA, and EDI, with up to 50% travel.

Qualifications

• Bachelor's degree or equivalent technical/business experience required.
• Deep functional/technical expertise in health plan risk adjustment (CMS-HCC/HHS-HCC) and quality analytics.
• Experience with Medicaid, Medicare (incl. MA) and ACA marketplace risk adjustment models.
• Advanced SQL and database expertise; capable of data validation and root-cause analysis.

Responsibilities

• Lead end-to-end solution architecture and technical design for enterprise-level implementations.
• Partner with health plans and providers to translate requirements into detailed implementation plans.
• Design data mappings, integration approaches, and data quality frameworks.
• Serve as escalation point for complex implementation issues and guide cross-functional teams.

Skills

CMS-HCC/HHS-HCC risk adjustment

Quality analytics (HEDIS/Star/QRS/PQA)

SQL/DB analytics

Healthcare data standards (HL7 FHIR/CC

ETL/ELT design

Data integration

Client-facing communication

Project leadership

Mentoring/leadership

Education

Bachelor's degree or equivalent (technical/business)

Tools

HL7 FHIR

CCDA

EDI

Job description

Veradigm seeks an Implementation Architect to lead end-to-end architectures and technical designs for Payer Analytics and Risk Adjustment implementations across Medicaid, Medicare, and ACA lines.

You will partner with clients, guide cross-functional delivery teams, ensure regulatory compliance, and architect scalable data integration solutions using HL7 FHIR, CCDA, and EDI, with up to 50% travel.