Position Description
Assess data functions for maturity, delivery health, gaps, overlaps, and handoff issues, and recommend practical improvements.
Advise Data team leaders on architecture, engineering, governance, quality, delivery, cost, and risk, and track recommendations through results.
Review and challenge solution designs, data models, architecture decisions, and engineering approaches before build.
Ensure adherence to Azure Databricks lakehouse, ADF, and medallion architecture standards, including Staging, Standard, EDH/Gold, and BSL.
Work hands-on with PySpark, Spark SQL, Delta Lake, Unity Catalog, Databricks Workflows, and ADF orchestration.
Build reference implementations, accelerators, and reusable patterns for adoption across Data teams.
Design and review FHIR R4 models, resources, and APIs for claims, clinical, provider, and member data, including US Core, CARIN Blue Button, Da Vinci, and PDex.
Guide CMS Interoperability delivery, including CMS-9115-F and CMS-0057-F requirements for Patient Access, Provider Directory, Payer-to-Payer, Provider Access, and Prior Authorization APIs.
Review data quality, testing, regression coverage, security, privacy, and compliance readiness, including HIPAA, PHI/PII, CMS, and state Medicaid requirements.
Translate requirements from Operations, Clinical, Finance, Actuarial, Quality/Stars, and Compliance into clear technical expectations.
Identify technical debt, duplicated effort, and cost inefficiencies and drive remediation.
Coach directors, architects, and engineers through design reviews, pairing, and knowledge sharing.
Partner with the Data PMO on prioritization, budgets, cloud spend, run-rate, and data risk.
Manage consulting and technology vendors, including SOWs, SLAs, staffing, rate cards, utilization, scope, performance, licensing, and knowledge transfer.
Support RFPs and POCs for data governance, data quality, MDM, testing, and observability solutions.
Partner with Procurement, Legal, Information Security, and Third-Party Risk on contracts, BAAs, and compliance.
Required Skills
- 15+ years of data and analytics experience, including senior advisory, architecture, or leadership experience across multiple data disciplines.
- Deep, current, hands-on Azure Databricks experience with PySpark, Spark SQL, Delta Lake, Unity Catalog, Workflows, and lakehouse/medallion architecture.
- Experience with Azure Data Factory, ADLS Gen2, and Azure security/networking fundamentals.
- Hands-on FHIR R4 experience, including resource modeling, US Core, CARIN, Da Vinci, FHIR servers, and/or Azure Health Data Services.
- Working knowledge of CMS-9115-F and CMS-0057-F and related interoperability APIs.
- Healthcare payer experience, particularly Medicaid, Medicare Advantage, or managed care.
- Experience across data governance, data quality, MDM/RDM, and QA/testing.
- Strong consulting/vendor management experience, including SOWs, SLAs, negotiations, utilization, and performance management.
- Ability to review business and technical requirements and identify gaps, risks, and misalignment.
- Proven ability to challenge and influence senior leaders without direct authority.
- Excellent executive communication skills and the ability to turn complex issues into clear, actionable recommendations.
Bonus Skills
- Experience with claims, eligibility, provider, pharmacy, quality/HEDIS, and encounter data.
- Big Four, tier-one technology consulting, or similar senior advisory experience.
- Knowledge of HIPAA, X12 EDI, TEFCA, and state Medicaid reporting.
- FinOps/cloud cost-management experience.
- Master’s degree or MBA.
- Certifications such as Databricks Data Engineer Professional, Azure Data Engineer/Solutions Architect, HL7 FHIR, CDMP, or TOGAF.