Spar Information Systems

Design and lead healthcare MMIS solution architecture ensuring compliance and integration. | Requires 10+ years IT experience with 5+ years in solution architecture and healthcare Medicaid systems, plus knowledge of enterprise architecture frameworks and cloud platforms. | Hello; Job Title: Solution Architect Job Location & Mode: United States, Remote, Willing to go to client site on a need basis Long Term Key Responsibilities 1. Solution Architecture & Design Design end-to-end MMIS solutions, including eligibility, claims processing, provider management, and payment modules. Define system architecture across application, data, and integration layers. Develop scalable, modular, and interoperable system designs aligned with MITA (Medicaid Information Technology Architecture) framework. Ensure solutions align with CMS guidelines and state Medicaid regulations. 2. Technical Leadership Provide architectural guidance to development, integration, and QA teams. Review and approve technical designs, code, and configurations. Lead architecture governance and design reviews. Mentor technical teams on best practices and emerging technologies. 3. Integration & Interoperability Design integrations with: o Federal and State systems (CMS, HHS) o Third-party vendors (EDI, clearinghouses) o Healthcare systems (EHR/EMR) Ensure adherence to interoperability standards such as: o HL7 / FHIR o X12 (EDI transactions) o APIs and microservices architecture 4. Data & Analytics Define data architecture including data flows, storage, and governance. Ensure support for reporting, analytics, and regulatory compliance. Oversee data migration and modernization initiatives. 5. Compliance & Security Ensure solutions comply with: o HIPAA o CMS Medicaid guidelines o State-specific requirements Implement robust security, privacy, and audit controls. 6. Modernization & Transformation Lead MMIS modernization initiatives (legacy transformation to cloud/microservices). Evaluate and adopt emerging technologies (AI/automation, cloud-native design). Support modular MMIS initiatives. 7. Stakeholder Management Collaborate with: o Business stakeholders o Program managers o State Medicaid agencies o Vendors and implementation partners Translate business requirements into technical architecture. Required Qualifications Education Bachelor's or Master's degree in Computer Science, Information Systems, or related field Experience 10+ years of IT experience with at least: o 5+ years in solution architecture o 5+ years in healthcare or Medicaid systems Proven experience working on MMIS or large healthcare payer systems Technical Skills Strong experience in: o Enterprise architecture frameworks (TOGAF preferred) o Cloud platforms (Azure/AWS/Google Cloud Platform) o Microservices and API design o Integration technologies (ESB, REST/SOAP) Knowledge of: o Medicaid domains (Claims, Eligibility, TPL, Provider Mgmt) o EDI X12 transactions (837, 834, 835, etc.) o HL7/FHIR Domain Knowledge Deep understanding of: o Medicaid business processes o CMS regulations and MITA framework o Healthcare compliance standards Preferred Skills Experience with MMIS modernization projects Knowledge of COTS Medicaid platforms (e.g., Conduent, Gainwell, Cognizant solutions) Certification in: o TOGAF / Cloud Architect (Azure/AWS) o Healthcare IT standards Key Competencies Strategic thinking and problem-solving Strong communication and stakeholder management Leadership and mentoring Ability to work in complex, regulated environments Success Metrics Successful delivery of MMIS architecture solutions Compliance adherence (zero audit issues) System scalability, uptime, and performance Stakeholder satisfaction