Medicare FIDE Architect

Medicare FIDE Architect



Location: Atlanta, GA



Experience: 10 Years






Keywords: Medicare FIDE, Solution Architecture, Data Architecture, System Integration, Cloud (AWS/Azure), Healthcare Payer, Medicaid, HIPAA, Technical Leadership



About the Role:



We are seeking an experienced and highly skilled Medicare FIDE Architect to provide technical leadership and strategic guidance for our critical IT projects related to Medicare Fully Integrated Dual Eligible (FIDE) programs. In this pivotal role, you will be responsible for designing, developing, and implementing robust, scalable, and compliant solutions that address the unique and complex requirements of integrated Medicare and Medicaid benefits management.



As the Medicare FIDE Architect, you will leverage your deep understanding of Medicare FIDE regulations, data models, system integrations, and the broader healthcare payer landscape to drive architectural decisions and ensure the successful delivery of our IT initiatives. You will collaborate closely with business stakeholders, product owners, development teams, and other architects to translate business needs and regulatory mandates into effective and innovative technical solutions.



Key Responsibilities:





Provide technical leadership and architectural guidance for all IT projects related to Medicare FIDE programs.

Design and document end-to-end solution architectures that meet the business requirements for Medicare FIDE programs, with a strong emphasis on scalability, performance, security, and compliance.

Define and maintain the data architecture for Medicare FIDE related data, ensuring data integrity, quality, and efficient data flow across various systems.

Develop and implement robust integration strategies between various internal and external systems involved in Medicare FIDE operations, including seamless integration with state Medicaid systems.

Architect and implement cloud-based solutions leveraging AWS or Azure services for Medicare FIDE applications and data storage, processing, and integration.

Collaborate effectively with business stakeholders, product owners, development teams, and other architects to thoroughly understand requirements and translate them into clear and concise technical solutions.

Assist in troubleshooting and resolving complex technical issues related to Medicare FIDE applications and integrations.

Ensure all solutions adhere to relevant healthcare industry standards and regulations, including HIPAA and other data privacy and security requirements.

Create and maintain comprehensive architectural documentation, including diagrams, data models, and technical specifications.

Participate in the evaluation and selection of new technologies and platforms relevant to Medicare FIDE initiatives.

Mentor and provide guidance to development teams on architectural best practices and standards.

Contribute to the development and maintenance of enterprise architecture standards and guidelines.





Qualifications and Experience:





Minimum of 10 years of experience in IT, with a significant focus on solution architecture and design.

Comprehensive knowledge of Medicare FIDE regulations, business processes, data requirements, and integration models.

Proven experience within the healthcare payer domain, specifically with Medicare and Medicaid programs.

Expertise in designing and implementing complex data models relevant to healthcare, including member enrollment, claims, eligibility, and provider data.

Sound experience in designing and implementing integrations between various healthcare systems (e.g., enrollment platforms, claims processing systems, data warehouses, state Medicaid systems).

Strong practical experience with cloud platforms (preferably AWS or Azure) and their relevant services for data storage, processing, and integration.

Thorough understanding of healthcare data security and privacy regulations, including HIPAA, and proven experience designing compliant solutions.

Proven ability to define and document solution architectures, including the creation of detailed diagrams, data flow diagrams, and technical specifications.

Excellent verbal and written communication skills, with the ability to effectively communicate complex technical concepts to both technical and 1 non-technical audiences.

Familiarity with Agile development practices and the ability to work effectively in an iterative and collaborative environment.

Bachelor's degree in Computer Science, Information Technology, or a related field (Master's degree preferred).





Preferred Skills:





Experience with specific Medicare and Medicaid technology platforms and systems.

Knowledge of data warehousing and business intelligence concepts within the healthcare domain.

Experience with API design and development.

Familiarity with security frameworks and best practices for cloud environments.