Data Architect- Health Care Payer

BBI is a multinational IT consulting services provider in the new-generation digital technology ecosystem. We are an extension of our client teams, providing solutions in niche technologies. Our key differentiators are quality and speed-to-market.

We embrace cloud technologies, digitization, data assimilation, machine learning, artificial intelligence, IoT, interpreted AI, robotic process automation, quality assurance, ambient computing and more.

Healthcare Payer Data Architect

Type: Full-time, W2
Experience: Senior-level
Functions: Data Architecture, Data Modeling, Data Integration, Data Governance, Technology Consulting
Industries: Healthcare Payers, Health Insurance, Healthcare Technology

Job Description:

The Healthcare Payer Data Architect will help establish a domain-oriented data architecture discipline across Member, Clinical, Provider, and Claims. Working with the client senior enterprise data architect, domain stakeholders, and data engineering teams, this role will assess the current architecture, define future-state designs, and develop practical transition roadmaps for a legacy, multi-tenant health platform spanning on-premises and cloud environments.

As part of BBI’s technology delivery and consulting practice, the architect will connect business meaning with technical design: where data resides, what it represents, how it is accessed, and how it supports payer operations and downstream consumers. This is a data architecture role within a broader enterprise architecture organization, not solely a project-specific platform implementation role. Architects will contribute domain or technical depth within a blended team rather than be expected to cover every specialty independently.

Job Duties include:

· Partner with the senior enterprise data architect to establish architecture standards, reusable patterns, design reviews, and decision documentation across Member, Clinical, Provider, and Claims.

· Work with payer business stakeholders to understand domain workflows, authoritative sources, data ownership, definitions, relationships, and consumption needs; translate these into conceptual, logical, and physical models.

· Assess current-state interface, integration, security, infrastructure, and technology architecture across on-premises and cloud environments; define future-state designs and phased transition roadmaps.

· Design source-to-target mappings, data contracts, and integration patterns using APIs, events, streaming, change-data-capture (CDC), batch or file transfers, and federation to feed lake house and downstream consumption layers.

· Evaluate legacy Oracle CDC flows through Informatica PowerCenter and Kafka; identify necessary data, reduce unused capture and processing, and recommend redesigns based on consumer needs.

· Assess fragmented implementations and consolidation opportunities across mainframe sources, databases, FHIR, Hadoop, Denodo, operational data stores (ODS), Kafka, and Confluent-related technologies.

· Design data products and consumption interfaces for APIs, portals, extracts, analytics, and AI or machine-learning use cases, balancing reuse, performance, and business value.

· Embed security, privacy, multi-tenancy, tenant isolation, and fine-grained access into target designs; evaluate alternatives to legacy table-, role-, and column-level controls while preserving required restrictions.

· Partner with security, privacy, and compliance stakeholders to translate tenant-specific rules and citizenship or geographic restrictions into enforceable controls for personal, payment-card, dental, and federal datasets, where applicable.

· Assess downstream impacts of source-schema changes, including primary and composite key changes; define compatibility, versioning, lineage, and communication practices for consumers and external vendors.

· Define architecture requirements for resiliency, performance, monitoring, data quality, and operational support at enterprise scale.

· Coordinate with data engineering on implementation designs, testing, reconciliation, and controlled promotion across development, test, and production; guide delivery through production rollout.

· Influence stakeholders, facilitate cross-domain decisions, and support change management as the organization shifts from project-intake assignments toward domain-oriented architecture.

REQUIRED QUALIFICATIONS

· Bachelor’s or graduate degree in computer science, information systems, or a related field.

· Substantial experience in enterprise data architecture and data modeling, including end-to-end delivery of complex data initiatives and current-state to future-state architecture planning.

· Healthcare payer domain experience with depth in one or more of Member, Clinical, Provider, or Claims, and the ability to collaborate across the remaining domains.

· Hands-on capability with medallion modeling, data services, streaming, and FHIR.

· Ability to set standards, design data models, define migration patterns, and mentor Highmark teams rather than just produce slideware.

· Hands-on expertise in conceptual, logical, and physical modeling, reverse engineering, source-to-target mapping, metadata, lineage, and authoritative-source identification.

· Strong SQL and database skills, with experience designing data warehouses or lakehouses and ETL/ELT integration processes.

· Ability to select and design appropriate API, event, streaming, CDC, batch/file, and federated integration patterns based on source characteristics and consumer requirements.

· Experience assessing legacy and cloud architectures and defining practical modernization, migration, and platform-consolidation roadmaps.

· Experience designing secure multi-tenant data solutions, tenant isolation, and fine-grained access controls; understanding of healthcare privacy and sensitive-data handling.

· Ability to assess schema and key changes, data quality, reconciliation, and downstream impacts across internal consumers and external data-sharing interfaces.

· Ability to translate resiliency, performance, monitoring, security, and privacy needs into actionable architecture requirements.

· Experience partnering with data engineering teams on design, testing, deployment, and promotion across development, test, and production.

· Strong communication, stakeholder influence, analytical problem-solving, and change-management skills; ability to explain trade-offs to business and technical audiences.

PREFERRED QUALIFICATIONS

· Deep healthcare payer domain knowledge (835 claims flows/processing, 834 enrollment / member / eligibility systems, 837 feeds the claims intake and adjudication systems, 835 provider directories/networks, member 360, value-based care data).

· Experience with the existing technology landscape: Oracle, Informatica PowerCenter, Kafka or Confluent, mainframe data sources, FHIR, Monte Carlo, Starburst, Atlan, DbT, Denodo, or ODS components. Depth in relevant technologies is valued; expertise in every listed product is not expected.

· Experience modernizing healthcare payer platforms that serve multiple health plans or tenants.

· Experience defining domain-oriented architecture operating models, reusable standards, data contracts, and architecture review practices.

· Experience designing data products and supporting analytics, AI or machine learning, portals, extracts, and API-based consumption.

· Experience interpreting tenant-specific geographic, citizenship, or differentiated sensitive-data access requirements in collaboration with security and compliance teams.

· Product-management experience or the ability to prioritize architecture work by business value, dependencies, and adoption needs.