We are seeking an experienced Healthcare Interoperability Architect to lead payer-side data exchange and integration strategies. You will design and implement cutting-edge interoperability solutions, leveraging HL7 FHIR, CCDA, X12, APIs, and platforms such as Epic Payer Platform, Availity, and SmileCDR. This role requires strong technical leadership, a deep understanding of US healthcare regulations (CMS, TEFCA, ONC), and expertise in interface engines like Mirth, Rhapsody, and Cloverleaf.
Key Responsibilities:
- Architect and implement healthcare data exchange and interoperability solutions for Payers, HIEs, and value-based care models.
- Provide technical leadership for integration strategies using HL7, FHIR, CCDA, X12, APIs, and IHE standards.
- Lead next-gen interoperability solutions aligned with regulatory compliance (CMS, ONC, TEFCA) and industry trends.
- Develop enterprise-wide data integration strategies using interface engines (Mirth, Rhapsody, Cloverleaf) and API-driven architectures.
- Work closely with product, engineering, and client teams to align business needs with interoperability best practices.
- Oversee large-scale implementation projects, ensuring security, compliance, and performance standards.
- Mentor and lead a team of healthcare interoperability experts, fostering innovation and technical excellence.
- Drive practice growth by identifying new business opportunities, service offerings, and strategic partnerships.
- Collaborate with payer clients to optimize interoperability frameworks, improving data exchange, care coordination, and analytics-driven decision-making.
Mandatory Technical Skills:
- 10+ years of experience in Healthcare Interoperability (payer-side).
- Deep expertise in HL7 FHIR, CCDA, X12, and healthcare API integration.
- Hands-on experience with Epic Payer Platform, Availity, SmileCDR, or equivalent solutions.
- Strong background in healthcare interface engines (Mirth, Rhapsody, Cloverleaf, or similar).
- In-depth knowledge of US healthcare data systems (EHRs, Payer Platforms, HIEs, PBMs, Lab Systems, PM Systems).
- Expertise in data integration methodologies (SFTP, APIs, TCP/IP, Snowflake, IHE, cloud-based interoperability solutions).
Preferred Qualifications:
- Experience addressing payer-side interoperability challenges and regulatory compliance (CMS, TEFCA, ONC).
- Certifications in HL7, FHIR, or interoperability standards.
- Prior experience working with large national payers, ACOs, CINs, HMOs, or MSOs
