Solution Architect

About the job

Leverage deep healthcare domain expertise to design, govern, and deliver enterprise-scale clinical, billing, and claims platforms. This role owns solution architecture across Power Platform, Azure integration services, APIs, and healthcare billing systems, ensuring secure, compliant, high-performance solutions that meet both business and regulatory requirements.
Key Responsibilities:

• Solution Architecture & Design: Architect enterprise healthcare platforms combining Power Platform (Canvas & Model-Driven), Dataverse, PowerApps Component Framework and Azure cloud services for high-performance, scalable, and secure solutions; Translate complex clinical workflows and pharmacy operations into modular, maintainable digital systems; Design full-stack integrations with REST APIs, Azure Functions, Logic Apps, and third-party payer/EHR systems; Develop and maintain structured data models and enforce schema validation in Dataverse to support clinical codes, visit types, fee schedules, and healthcare workflow processes; Ensure HIPAA compliance, PHI security, RBAC, and auditability across all layers of the solution.
• End-to-End Ownership: Lead full lifecycle delivery from requirements elicitation, technical architecture, and solution design to implementation, testing, deployment, and production stabilization; Own clinical encounter workflows, billing logic, and claims-ready payloads, including CPT/HCPCS mapping, modifier assignment, insurance eligibility, prior authorization, and ABN handling; Optimize real-time payment workflows for copay, out-of-pocket, and prior authorization processes within Canvas Apps and backend APIs; Serve as technical escalation point for cross-layer dependencies spanning UI, Dataverse, PCF components, Azure services, and payer integrations.
• AI & Copilot Innovation: Architect AI-driven clinical and operational workflows leveraging Azure AI Foundry Services, OpenAI/GenAI, and low-code AI integrations within Power Platform; Implement predictive coding, automated claims validation, modifier recommendations, and eligibility checks to reduce errors and accelerate reimbursement; Integrate AI capabilities to enhance clinical decision support, patient triage, and workflow automation in both staff and patient-facing applications; Continuously evaluate emerging AI/ML technologies to optimize operational efficiency, claim accuracy, and patient outcomes.
• Team Leadership & Mentorship: Lead and mentor distributed engineering teams on Power Platform best practices, full-stack development, PCF component design, Azure integration, and healthcare workflow modeling across multiple time zones; Conduct architecture reviews, code reviews, and performance tuning sessions to enforce high-quality, modular, and scalable solutions; Guide teams on delegation-friendly Dataverse queries, lazy loading, Named Formulas, API orchestration, and claims workflow automation; Foster a culture of technical excellence, cross-domain knowledge sharing, and adherence to healthcare compliance standards.
• Collaboration & Alignment: Collaborate with clinicians, pharmacy staff, DME coordinators, operational leads, and administrative stakeholders to translate real-world healthcare workflows into digital solutions; Facilitate workshops and technical reviews to align business requirements with architecture, compliance standards, and technical feasibility; Ensure workflow standardization, consistent service identifiers, CPT/HCPCS mapping, and payload accuracy across modules; Integrate clinical and billing systems with enterprise reporting, payer-specific logic, and claims processing platforms.
• Microsoft Product Team Collaboration: Partner with Microsoft engineering, Power CAT, and FastTrack teams to validate solution architecture, adopt platform best practices, and influence roadmap decisions; Represent the organization at Microsoft conferences and community events as a subject matter expert in healthcare digital transformation on Power Platform and Azure; Provide guidance on advanced Power Platform patterns, PCF extensibility, Azure cloud design, and enterprise-grade compliance architecture; Stay current on Power Platform, Azure, AI/ML, and healthcare technology innovations to inform long-term solution strategy.
• Continuous Improvement: Optimize application performance, operational efficiency, and workflow automation across clinical, billing, and DME systems; Implement CI/CD pipelines, DevOps automation, versioned managed solutions, and automated testing to ensure reliability and reproducibility; Lead data validation, payload standardization, and fee schedule updates to reduce errors, improve claim accuracy, and ensure regulatory compliance; Evaluate and adopt emerging technologies (AI, ML, Azure cloud services, integration patterns) to enhance user experience, clinical throughput, and reimbursement outcomes.

Bachelor’s degree in Computer Engineering or similarly technical field; Eight (8) years’ experience with systems architecture, including at least five (5) years of specific experience with Microsoft Cloud products including Power Platform and Azure; and each of the following:

(1) Must be current holder of Microsoft FastTrack Recognized Solution Architect (FTRSA) designation (Power Platform track or Dynamics 365 track).

(2) Must have completed formal HIPAA training for software development;

(3) Demonstrated expertise in each of the following: (a) Microsoft Power Platform and Azure architecture patterns, with proven experience translating complex healthcare workflows, clinical encounters, insurance eligibility, billing, and claims into scalable, auditable digital systems; (b) The full medical billing cycle, including patient registration, insurance verification, charge capture, and final payment posting.

(4) Demonstrated experience with each of the following: (a) Designing and implementing secure PHI transmission pipelines to external systems and third-party integrations, with hands-on experience structuring data flows that comply with BAA obligations, enforcing TLS/mTLS for data in transit, managing encryption key lifecycles, and ensuring end-to-end PHI integrity across system boundaries; (b) Engineering HIPAA-compliant audit logging and access control systems from the ground up, including tamper-evident audit trails, automated access reviews, field-level encryption of PHI within databases, and role-based access models that enforce minimum necessary access at both the application and data layer; (c) Identifying and remediating HIPAA security risks within software systems, conducting technical risk assessments, threat modeling data flows that touch PHI, implementing breach detection mechanisms, and ensuring applications meet the required administrative, physical, and technical safeguard standards under the Security Rule; (d) Making architectural decisions in production healthcare systems that directly satisfy HIPAA Privacy and Security Rules at an implementation level, including the full scope of technical safeguard requirements including encryption standards, access controls, audit controls, and integrity controls; (e) Architecting automated "Claim Scrubbers" within the medical billing workflow to validate data against payer-specific edits prior to submission.

(5) Demonstrated knowledge of each of the following: (a) ICD-10/11, CPT, and HCPCS coding structures and how they impact the data schema of a D365 Healthcare implementation; (b) National Council for Prescription Drug Programs (NCPDP) Telecommunication Standard (D.0) for real-time pharmacy adjudication; (c) Managing and automating the resolution of medical billing rejections (TA1, 999, and 277CA) resulting from technical or formatting errors at the clearinghouse level; (d) Architecting medical billing workflows for denial management, specifically using 835 Remittance Advice codes to trigger automated appeals and medical necessity reviews.