Implementation Architect

Overview

Provide architecture and design for integrating Edifecs solutions into customer environment to meet customer business needs and technical needs for performance, scalability, maintainability and availability. Mentor implementation consultants and review work products/designs delivered by implementation consultants to ensure that they meet prescribed architecture. Provide software code and other artifacts for complex scenarios. Interface with Edifecs engineering team to understand product reference architecture and convert it into implementation architecture templates.

Provide guidance to partners who are implementing Edifecs solution from time to time. Troubleshoot critical and complex issues in production that are escalated by support and implementation teams. Create reusable assets such as configuration templates, code templates and other extensions to product that can be leveraged across multiple implementations.

• Architect robust, scalable, and secure solutions across payer systems such as:
  • Claims Adjudication Engines (e.g., Health Rules Payor, QNXT, Facets)
  • Member Enrollment & Eligibility
  • Provider Data Management
  • Billing & Remittance Systems
• Define logical, physical, and integration architectures for service orchestration, and data flows.
• Develop architecture artifacts: solution blueprints, API/interface specifications, sequence diagrams and deployment models (cloud/hybrid).

• Design real-time and batch integrations using:
  • EDI (X12: 834, 837, 835, 270/271, 276/277, 278)
  • FHIR (CMS Interoperability APIs)
  • HL7 v2/v3
• Implement service-based integrations via RESTful APIs, SOAP Web Services, ESBs, and iPaaS platforms.
• Lead canonical data modeling and interface definition for intra-platform communication.

• Collaborate with Dev Ops and Infrastructure teams to deploy scalable solutions on:
  • AWS (EC2, Lambda, S3, RDS, API Gateway)
  • Azure (App Services, Logic Apps, Functions, Event Grid)
• Define containerization and orchestration strategies using Docker, Kubernetes, Helm for microservices deployment.

• Develop data migration strategies for legacy-to-modern system transformations, ensuring data integrity, lineage, and auditability.
• Design ETL/ELT processes for payer data domains using Edifecs tools.
• Conduct performance tuning for high-volume transactional systems (claims and eligibility processing pipelines).

• Ensure solutions are HIPAA-compliant.
• Implement role-based access controls (RBAC), encryption at rest and in transit, and OAuth2/OpenID protocols for FHIR APIs.
• Document architectural decisions using enterprise architecture tools (Sparx EA, Archi Mate, Visio).

• Partner with business analysts, SMEs, and delivery leads to align technical design with payer business requirements.
• Serve as a hands-on technical lead during implementation, reviewing code, guiding developers, and conducting design reviews.
• Support Agile ceremonies (PI Planning, Sprint Reviews) and contribute to technical backlog grooming.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

• Bachelor’s degree or foreign equivalent degree in Computer Science, Engineering, or IT related field.
• 8 years of progressive, post-baccalaureate experience (within the past 8 years) in the healthcare industry as an Implementation Architect, Software Engineer, or related occupation.
• Hands-on experience with core payer platforms such as Facets, QNXT, Health Edge, Epic Tapestry, or equivalent
• Deep understanding of healthcare interoperability standards (HL7 v2, HL7 FHIR, X12 EDI, NCPDP, C-CDA).

• Deep understanding of FHIR R4 structure, resource types, profiles, and terminology (LOINC, SNOMED, ICD).
• Familiarity with data formats: JSON, XML, HL7v2 messages, X12, flat files (CSV,…