Solutions Architect Medicare & Medicaid

We are seeking a highly skilled Solutions Architect / Integration Architect with deep expertise in Medicare and Medicaid systems and a proven ability to work independently. The ideal candidate will have strong software development experience, hands-on knowledge of Java (mandatory), and a solid foundation in architecture principles. Familiarity with .NET is a plus.

This role requires significant experience in system integration, cloud platforms (Azure preferred), and Kafka (must-have) for real-time data streaming and integration. The architect will be responsible for designing and implementing scalable, high-performance solutions, ensuring compliance with healthcare regulations, and leading solutioning efforts across complex enterprise systems.

KEY RESPONSIBILITIES

Architecture & Solutioning

• Architect and design solutions for Medicare and Medicaid systems, ensuring compliance with industry regulations (HIPAA, CMS) and security best practices.
• Collaborate with enterprise architects and stakeholders to define technical architecture strategies aligned with business goals.
• Lead the design and implementation of healthcare insurance solutions (eligibility, claims processing, member services, provider networks).
• Work independently in providing end-to-end solutioning, technical guidance, and architectural best practices.

Integration & Cloud

• Design and integrate complex systems, ensuring interoperability across diverse platforms (clinical systems, claims processing, data warehouses).
• Leverage Kafka (must-have) for real-time event streaming, data integration, and high-throughput processing.
• Implement cloud-based solutions in Azure (preferred) with focus on API management, data lakes, and structured data sets.
• Support API integration strategies, cloud-native services, and enterprise integration patterns (MuleSoft or similar experience is a plus).
• Agile Delivery & Technical Leadership
• Work within Agile methodologies (Scrum/Kanban), contributing to backlog grooming, sprint planning, and iterative delivery.
• Provide technical leadership, mentoring, and collaboration with development teams.
• Oversee the full SDLC from requirements gathering and design through to deployment and support.
• Compliance & Documentation
• Ensure compliance with healthcare interoperability standards (EDI 835/837, HL7, FHIR).
• Maintain high-quality technical documentation and architecture design artifacts.
• Support DevOps practices, CI/CD pipelines, and security/compliance controls in cloud environments.

Required Qualifications & Experience

• 8+ years of IT architecture experience, with at least 5 years in solution/integration architecture.
• Strong hands-on development background in Java (mandatory); .NET experience is a plus.
• Proven expertise with Kafka (must-have) for data streaming and integration.
• Deep Medicare and Medicaid experience (must-have) with ability to work independently on solutioning.
• Strong knowledge of healthcare data formats (EDI, HL7, FHIR) and compliance standards (HIPAA).
• Experience with cloud platforms (Azure required; AWS a plus).
• Expertise in system integration, APIs, middleware, and enterprise-scale architecture.
• Strong communication and stakeholder management skills to present solutions to technical and non-technical audiences.
• Technical writing and documentation skills.

Preferred Skills

• Experience with MuleSoft or other API/integration platforms.
• Familiarity with healthcare applications such as Epic, Facets, or similar.
• Knowledge of microservices, cloud-native design patterns, and big data/analytics integration.
• Experience with DevOps practices, CI/CD pipelines, and cloud security.
• TOGAF or ITIL certification is a plus.