Data Architect with a background on pharmacy benefit management (PBM)

We are seeking a Data Architect with deep expertise in healthcare and pharmacy benefit management (PBM) data systems, particularly those tied to government programs such as Medicaid and Medicare. You will lead the design and development of secure, scalable, and compliant cloud-based architectures that support analytics and applications across pharmaceutical, Medicaid, and Medicare domains. In this role, you ll collaborate with engineering, product, and compliance teams to ensure solutions meet federal healthcare standards and support business performance.

This role requires hands-on experience with Snowflake, Matillion, and AWS (or similar technologies), along with strong knowledge of data governance, healthcare standards, and a strategic approach to building scalable, future-ready data systems.

Key Responsibilities:

Core Architecture and Engineering

• Design and implement scalable cloud-native architecture, integrating healthcare and PBM data to support Medicare drug pricing, compliance reporting and regulatory requirements.
• Own and maintain data models, data lakes, and data marts supporting Medicare Part D, Medicaid rebates, STAR ratings, DIR fees, and related programs.

Data Integration and Consumption

• Design systems that support downstream processes and data consumers, including BI tools, analytics teams, and operational end users.
• Act as the main point of contact between business stakeholders and the data engineering team for data-related needs.

Governance, Compliance & Security

• Design and implement data governance frameworks including metadata management to ensure traceability, auditability, and compliance with data quality, security, and HIPAA standards.
• Translate CMS and HHS mandates related to Medicare and Medicaid into applicable data standards and technical solutions.

Cross-Functional Collaboration

• Collaborate across Engineering, Analytics, DevOps, Product and Regulatory teams to define Critical Data Elements (CDEs) and align on business and technical requirements.

Scalability & Strategic Planning

• Develop and implement strategies for data security, capacity planning, scalability, backup and recovery, disaster preparedness, and long-term data archiving.
• Address architectural problems related to system integration and compatibility using optimal solutions and guided by industry best practices.
• Evaluate and apply AI/ML techniques to support use cases for claims, benefits, and member analysis.

Leadership

• Mentor and provide technical guidance to the data engineering team.

Required Qualifications

• 10+ years of experience in data architecture, including 5+ years in the healthcare or PBM industry and 3+ years in Medicaid/Medicare-specific work (preferred).
• 5 + years of combined experience with Snowflake, AWS, and Matillion.
• Hands-on experience with: Cloud Data Platforms: Snowflake (or similar cloud-based data warehouses). ETL/ELT Tools: Matillion (or similar tools).AWS Ecosystem: AWS services such as S3, Lambda, SNS, SQL, CloudWatch, Cognito, etc.CI/CD and Automation: Experience with CI/CD pipelines and data workflow automation.Data Modeling: dbt, ERwin or similar.Data Governance: Collibra or similar for metadata, lineage, and governance.
• Advanced proficiency in SQL and Python for data engineering and analysis.
• Strong working knowledge of healthcare and pharmaceutical data standards, including HL7, FHIR, NCPDP, Medicare Part D prescription data, CMS reporting requirements, EDI (834, 835, 837, 820), and frameworks such as IDMP, SPOR, and product registration.
• In-depth experience with PBM data structures, including claims, formulary, eligibility, rebate contracts, and provider data.
• Proven ability to implement enterprise-level data solutions for large healthcare organizations.
• Strong foundation in data governance, security, and compliance frameworks (e.g., HIPAA, 21 CFR Part 11, GDPR), with experience implementing data quality, metadata, and master data management standards.
• Experience with both SQL and NoSQL databases.
• Demonstrated excellence in problem-solving, communication, presentation, initiative, and leadership across cross-functional data teams.
• Proven ability to thrive in fast-paced, dynamic environments while managing shifting priorities and multiple concurrent projects.
• Legally authorized to work in the U.S. without restrictions.

Preferred Qualifications

• Master s degree in Computer Science, Information Systems, or a related field.
• Hands-on experience developing data integration pipelines across both on-premises and cloud environments, using tools such as Matillion, Informatica, or similar.
• Hands-on experience working with modern cloud-native data platforms (e.g., Snowflake, AWS, BigQuery) and implementing real-time data streaming solutions using technologies like Kafka or Kinesis.
• Relevant certifications are a plus, such as:
• AWS Certified Solutions Architect,
• Snowflake SnowPro,
• DAMA certification in Data Governance.