EHR Platform Architecture Consultant

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About Alpaca Health

Alpaca Health empowers autism care providers to deliver the highest quality ABA services. We fully manage non-clinical administrative functions — scheduling, intake, billing, documentation, claims, and more — so providers at Alpaca-powered clinics can focus entirely on clinical care.

We7re growing quickly and well-capitalized, having raised $4M+ from leading VCs like Adverb Ventures and South Park Commons. We have grown quickly from 0 to over 1M in annual run rate and over 5M in GMV in just a few months.

We7re looking for an experienced EHR Platform Architecture Consultant to partner with our engineering leadership on a short-term, high-impact engagement. Your mission:
audit Alpaca7s existing EHR architecture and data model, identify bottlenecks, and propose foundational improvements that unlock long-term scalability.

In this role, you will:

• Review how ABA clinics operate across scheduling, clinical documentation, data collection, billing, EVV, and claims.

• Understand how our platform supports these workflows today — and where breakdowns occur.

• Evaluate our current domain models (appointments, session notes, treatment plans, pay periods, claims, etc.) across Python + MongoDB.

• Analyze schema design, document relationships, indexing strategy, event flow, and consistency across modules.

• Assess compliance-related needs (audit logs, versioning, PHI boundaries, RBAC).

• Recommend architectural changes to improve reliability, correctness, and long-term extensibility.

• Flag structural issues that may cause future problems (e.g., ledger consistency, document bloat, inconsistent time-zone handling, overly coupled modules).

• Prioritize changes by business impact, engineering risk, and implementation complexity.

• Provide guidance on whether and how to incorporate FHIR resources or Medplum-style abstractions.

• Suggest patterns for versioning clinical documents, supporting note signing, and unifying scheduling + billing + clinical domains.

• Review our LLM-driven workflows and recommend safer patterns for auditability and correctness.

• Work directly with our CTO and engineering team.

• Deliver clear written recommendations, diagrams, and migration paths.

• Optionally advise during implementation as we execute your recommendations.

This engagement does not require hands-on coding — but does require extremely deep architectural and EHR expertise.

As Alpaca accelerates, we need a strong architectural foundation to support:

• complex ABA-specific scheduling logic

• real-time clinical data collection

• LLM-powered documentation

• EVV-compliant visit tracking

• claim generation and revenue cycles

• payroll and payout systems

• multi-clinic scalability and data isolation

Your work will set the trajectory of Alpaca7s platform for years.

You may be a fit if you:

• Have deep experience designing or auditing EHRs (Epic, Athena, Simple Practice, Rethink, Medplum, etc.)

• Understand healthcare data models, particularly structured clinical documentation, audit trails, and insurance workflows.

• Have strong opinions on schema design, normalization vs denormalization, event models, and domain boundaries.

• Comfortably evaluate systems across MongoDB, Python, cloud architectures, and LLM-driven workflows.

• Can translate messy real-world clinical workflows into clean, extensible domain models.

• Communicate clearly and produce high-quality architectural documents.

• Contract / Consultant (short-term or part-time)

• Remote or NYC-based

• Duration: 2–6 weeks
  , depending on depth

• Deliverables:

  • Architecture audit

  • Data model audit

  • Prioritized recommendations

  • Migration / refactor roadmap

  • Optional implementation advisory