Remote EHR Architecture Consultant Scalable Health Data

Please navigate to our new careers page.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.

We’re 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.

We’re looking for an experienced EHR Platform Architecture Consultant to partner with our engineering leadership on a short-term, high-impact engagement. Your mission: audit Alpaca’s 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 Alpaca’s 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