Healthcare Integration Architect

Position Title: Healthcare Integration Architect
Location: US - Remote (EST hours)
Job Type: Full-Time

Let's create our future together at The AES Group!

About The AES Group:

The AES Group is a premier technology consulting company that has been bringing businesses and talent together for over 20 years to deliver the most innovative technology solutions that create the most positive impact on society. AES has helped over 40 business enterprises, including Fortune 500 companies, engage their customers, empower their employees, and transform their business operations with the power of cloud, data, AI, and other emerging technologies.

About the Role:

We are looking for a hands-on Healthcare Integration Architect to lead the design, development, and implementation of integrated technology solutions across the healthcare payer ecosystem. This role is ideal for someone who thrives at the intersection of architecture and execution - someone who can shape technical direction while actively building and integrating systems that drive real impact in care management and population health.

You'll play a key role in enabling end-to-end interoperability, driving data integration across clinical, claims, and social datasets, and building the infrastructure that supports member engagement, risk insights, and value-based care delivery.

Key Responsibilities:

• Design and implement robust integration solutions between payer care management platforms, PHM tools, EHRs, and enterprise data systems.
• Build scalable data pipelines and services that enable real-time and batch data exchange across internal and external healthcare systems.
• Work directly with engineering teams to develop and deploy FHIR/HL7 interfaces, APIs, and secure data workflows supporting care coordination and quality initiatives.
• Integrate data from diverse sources (clinical, claims, SDoH) to support risk stratification, utilization management, and member outreach.
• Collaborate with stakeholders to understand clinical and operational requirements, translating them into technical designs and working code.
• Ensure all implementations meet regulatory and security requirements (e.g., HIPAA, CMS), as well as interoperability standards (FHIR, HL7, CCD).
• Provide architectural input on system scalability, resiliency, and performance - and help guide continuous improvement across platforms.
• Participate in platform selection, proof-of-concepts, and vendor integrations as needed.

Qualifications:

• 10+ years of experience in healthcare software engineering, integration development, or data architecture, with a strong track record of hands-on implementation.
• Deep understanding of payer systems such as care management, utilization review, and population health platforms.
• Proficiency in healthcare data standards (FHIR, HL7, X12, CCD) and integration frameworks (e.g., Mirth Connect, APIs, ETL tools).
• Strong skills in scripting or development languages (e.g., Python, Java, SQL) and working knowledge of cloud infrastructure (AWS, Google Cloud Platform, or Azure).
• Experience integrating with common PHM tools (e.g., Innovaccer, Arcadia, Epic Healthy Planet) or building custom data pipelines across systems.
• Ability to work cross-functionally with data, clinical, and engineering teams to deliver end-to-end technical solutions.
• Bachelor's degree in Computer Science, Engineering, Health Informatics, or a related field.

Healthcare Interoperability Standards (Payer-Focused)

• HL7 FHIR
• EDI X12
• HL7 v2/v3
• CDA/CCD
• DICOM

Integration Engines & Middleware

• Mirth Connect (NextGen) / Rhapsody / Cloverleaf
• Informatica, Boomi, MuleSoft
• InterSystems HealthShare
• Kafka / RabbitMQ / NATS

AI & ML Integration for Payers

• Risk Adjustment & HCC Coding NLP to extract codes from charts or notes (e.g., using ZeOmega's Jiva or external AI APIs).
• Member Engagement AI chatbots, outreach personalization, dropout prediction.
• Fraud, Waste & Abuse Detection Pattern recognition and anomaly detection in claims.
• Generative AI (e.g., GPT, MedPaLM) Appeals summarization, documentation generation, care notes.
• Care Management Augmentation AI-driven prioritization and intelligent alerting in Zyter TruCare and ZeOmega Jiva.

APIs & Web Services

• FHIR APIs
• EDI gateways and APIs
• ZeOmega & Zyter APIs
• REST / GraphQL

Security, Compliance & Governance

• SMART on FHIR / OAuth2 / OpenID Connect
• HIPAA / CMS compliance
• Consent Management APIs
• Auditability, model explainability, fairness tracking

Payer Systems & Platforms

• Claims and Core Admin Systems TriZetto Facets/QNXT, HealthEdge, Cognizant, Evolent
• Population Health & Care Management - Zyter TruCare, ZeOmega Jiva
• CRM / Member Portals Salesforce Health Cloud, Pegasystems
• EDI Clearinghouses Change Healthcare, Availity, Waystar
• Data Platforms Snowflake, Azure Synapse, Redshift, Databricks

Programming & Deployment Tools

• Languages Python, Java, Node.js, C#
• Data Formats X12 EDI, JSON, XML, HL7, FHIR Bundles
• Model Ops SageMaker, Azure ML, Vertex AI, DataRobot
• Infrastructure Docker, Kubernetes, Airflow for orchestration

Preferred Skills:

• Familiarity with value-based care, quality programs (HEDIS/STARS), and member-centric workflows.
• Experience implementing FHIR APIs, secure data exchange, or healthcare integration platforms.
• Exposure to health data modeling, real-world evidence (RWE), or social determinants of health (SDoH) data.
• Strong problem-solving skills and comfort working in fast-paced, iterative environments.

What we offer:

• Competitive pay with a focus on your performance and outcomes
• Professional growth opportunities that enable you to connect and collaborate with industry leaders and drive business value for some of the world's most innovative and forward-thinking companies
• Open and collaborative environment where your contributions help shape The AES Group into something that works for you, not just a company you happen to work for

Let your future start with The AES Group and join our mission to create the most positive impact on society with the power of technology. Apply now.