Healthcare Payer Enterprise Architect

We are seeking an experienced Healthcare Payer Enterprise Architect to define enterprise architecture strategy, drive modernization initiatives, and design scalable technology solutions across healthcare payer platforms. The ideal candidate will have strong expertise in U.S. healthcare payer operations, enterprise architecture frameworks, cloud technologies, integration standards, and emerging AI capabilities.

Required Skills & Experience

• 12+ years of IT experience with 5+ years in Enterprise/Solution Architecture
• Strong expertise in the U.S. Healthcare Payer domain
• Deep understanding of payer processes including claims, eligibility, benefits, provider workflows, care management, and utilization management
• Experience with TOGAF or equivalent Enterprise Architecture frameworks
• Strong knowledge of cloud platforms (AWS/Azure/GCP), APIs, microservices, data architecture, and integration patterns
• Experience with healthcare interoperability standards including HL7, FHIR, and EDI X12
• Knowledge of payer platforms, digital ecosystems, and modernization initiatives
• Experience with AI/ML/GenAI solutions, including utilization management, prior authorization, automation, and analytics use cases
• Strong communication, stakeholder management, and consulting skills

Roles and Responsibilities

• Define and govern enterprise architecture strategy, standards, and roadmaps
• Develop current-state, target-state, and transformation architecture for payer systems
• Lead solution architecture across claims, enrollment, provider, care management, and digital platforms
• Drive cloud adoption, API-first architecture, microservices, and modernization initiatives
• Define AI architecture patterns, data strategies, and automation opportunities
• Ensure compliance with healthcare standards and regulations such as HIPAA, CMS, and NCQA
• Lead architecture governance, review boards, and collaboration across business and technology teams
• Provide strategic technology guidance to senior stakeholders

Preferred Skills

• Experience leading large-scale healthcare transformation programs
• Strong business-to-technology alignment capabilities
• Experience mentoring architecture teams and driving enterprise-level initiatives