Principal Architect - Remote or Hybrid in MN and DC

Principal Architect - Remote or Hybrid in MN and DC (2361105)

Optum Tech is a global leader in health care innovation. Our teams develop cutting‑edge solutions that help people live healthier lives and make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care’s most complex challenges. Your contributions here have the potential to change lives.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

• Define and drive the data architecture for Optum Health’s Risk Adjustment and Quality platform
• Architect scalable, secure, and governed solutions that integrate claims, encounters, eligibility, provider, member, EHR, lab, pharmacy, and other clinical data into a unified data platform
• Design canonical, logical, and physical data models for core healthcare domains such as member/patient, provider, coverage, diagnosis, condition, encounter, procedure, medication, lab result, risk score, quality measure, and gap status
• Lead architecture for data products and pipelines that support:
  • Risk Adjustment Framework
  • Prospective and retrospective risk adjustment workflows
  • Coding capture and suspecting
  • HEDIS / Stars / NCQA reporting and gap closure
  • Quality performance analytics and operational workflows
  • Establish architecture patterns for ingesting and normalizing data from:
  • X12 transactions (e.g., 837, 835, 834, 270/271)
  • HL7 v2/v3 and CCD/C-CDA
  • FHIR APIs and bulk interoperability feeds
  • EHR, practice management, payer, and external partner systems
• Partner with business and domain leaders to ensure architecture supports the nuances of Medicare Advantage, quality programs, evolving CMS and NCQA requirements, and downstream operational use cases
• Ensure full alignment with HIPAA, PHI, privacy, security, access control, auditability, and data retention requirements
• Define and implement standards for data quality, lineage, metadata, semantic consistency, reconciliation, and traceability from source systems through measure/risk outputs
• Drive architecture decisions for identity resolution, provider and member mastering, source‑of‑truth alignment, and data harmonization across payer and provider ecosystems
• Collaborate with data engineering and platform teams on cloud‑native architecture patterns including warehouse design, API‑led integration, event‑driven patterns, and high‑volume batch/near‑real‑time processing
• Support audit‑readiness for risk and quality programs, including traceability needed for RADV, NCQA validation/audits, and internal control frameworks
• Lead architecture reviews, create reusable standards and design patterns, and mentor senior engineers and architects across the organization
• Communicate complex technical concepts clearly to executive, operational, and clinical stakeholders

• Undergraduate degree in applicable area of expertise or equivalent experience
• 5+ years of experience in healthcare data architecture, data engineering, enterprise data, or information architecture, with increasing scope and seniority
• Demonstrated experience supporting HEDIS, Stars, and NCQA quality data needs, including quality measure data sourcing, attribution, gap identification, and reporting architecture
• Demonstrated expertise with healthcare interoperability standards including: FHIR, HL7, X12
• Demonstrated solid data modeling skills, including canonical models, dimensional models, and data product/domain‑oriented design

• Master’s degree in a relevant technical or healthcare field
• 2+ years in a lead or principal architecture role designing enterprise‑scale healthcare data solutions
• Experience designing solutions on modern cloud data platforms and enterprise data ecosystems
• Experience establishing or enforcing data governance disciplines such as lineage, metadata, data quality controls, stewardship, and source‑to‑target traceability
• Experience in Medicare Advantage and other value‑based care environments
• Experience with RAPS/EDPS,…