Description

Job Description:

Must-Have Skills

• 12+ years in data engineering and analytics; 3+ years as a Technical or Solution Architect on enterprise-scale, multi-workstream data programs
• Hands-on expertise in Microsoft Fabric — OneLake, Fabric Data Factory, Lakehouses, Delta Lake, medallion architecture, and point-in-time reconstruction patterns
• Proven experience designing data quality and intake control frameworks — schema validation, SLA checks, reconciliation, exception triage queues, and quarantine/reject workflows
• Deep experience designing canonical data models for complex transactional domains — insurance claims, healthcare, or financial services strongly preferred
• Hands-on experience with Azure AI Services — Azure Document Intelligence (Form Recognizer) or equivalent for unstructured/semi-structured document extraction integrated into pipelines
• Strong Python and SQL — you review and write production-grade code, not just diagrams
• Demonstrated experience leading customer-facing technical engagements with full delivery accountability — you own the outcome, not just the architecture review

Good to Have

• Experience with Azure Databricks for large-scale historical data processing or complex transformations alongside Fabric
• Power BI embedded reporting or Fabric Real-Time Intelligence experience
• Familiarity with medical stop loss insurance, TPA ecosystems, or healthcare claims data formats (837, 835)
• Microsoft Fabric Analytics Engineer (DP-600) or Azure AI Engineer Associate (AI-102) certification

Role Summary

We are looking for a seasoned Technical Architect to own end-to-end solution architecture for a specialty medical stop loss insurance enterprise's CEO-prioritized claims data platform modernization. You will design and govern a production-ready Microsoft Fabric lakehouse — covering the full medallion stack from ingestion through curated Gold layer views — while serving as the primary technical authority in direct engagement with client leadership. This is a hands-on architecture role embedded in the delivery team, with a hard production deadline and real commercial stakes on every design decision.

Why This Role Matters

The customer processes 50,000+ claims annually across 250+ Third-Party Administrators using a fragmented, manual intake stack. The platform you architect will eliminate that friction, automate eligibility workflows, and become the data foundation on which all future AI/ML, BI, and operational capabilities are built. Phase 1 establishes a production-proven foundation on five priority TPAs — the architecture you get right here sets the pattern for the full TPA network in subsequent phases.

What You'll Do

Architecture & Solution Design

• Design and govern the OneLake medallion architecture (Bronze / Silver / Gold) for claims, eligibility, and policy/contract data across five Phase 1 TPAs
• Define the AI-assisted schema registry — versioned alias handling for ~10 TPA format variants each, with drift detection and forward-compatible schema evolution
• Architect the canonical claims data model: standardized diagnosis/procedure/revenue codes, member/dependent/subscriber normalization, and full adjustment/void/reversal handling
• Specify all six Gold layer curated 360 views — Insured/Claimant, Policy/Contract, Claim/Claim Line, Large Claimant, Clinical/Case Signal, and Underwriting/Renewal — and govern delivery to acceptance criteria
• Design the custom rule-based MDM claimant mastering service with probabilistic matching, human-in-the-loop review UI, and historical plus current-state coverage

Data Platform & AI Integration

• Govern the Fabric Data Factory pipeline architecture for batch file intake (xlsx, csv, txt) with SLA monitoring, control totals, duplicate detection, and quarantine/reject workflows
• Architect the Azure Document Intelligence integration for eligibility PDF and screenshot extraction, including human-in-the-loop validation workflow design
• Define Microsoft Purview adoption for data classification, lineage tracking, and 7-year PHI retention compliance
• Embed client's WinAIDM AI accelerators across all pipeline workstreams — Data Ingestion Agent, Data Quality Agent, Data Transformation Agent, and Reporter Agent
• Drive the cross-validation strategy comparing new platform outputs against existing platform for accuracy and directional consistency

Governance, Security & Compliance

• Design PHI access controls and data masking patterns enabling offshore development while meeting US-only PHI requirements
• Establish the four-role RBAC model (Admin, IT Support, Regular User, Read-Only) across the eligibility portal and all operational UIs
• Deliver architecture documentation, runbooks, and the Gold layer consumption specification for the client's downstream claim creation platform

Technical Leadership

• Lead sprint zero discovery — backlog definition, TPA file layout review, RACI, tooling access, and delivery cadence establishment
• Conduct architecture decision reviews and set engineering standards across all workstreams and the full offshore team
• Mentor the offshore Technical Architect and Technical Lead on Fabric patterns, WinAIDM usage, and medallion implementation best practices

Client Engagement

• Serve as the primary technical voice in stakeholder meetings with client technology and business leadership — translating platform decisions into clear, decision-ready recommendations
• Partner with the client's internal team to define Gold layer consumption spec and integration handoff criteria for the downstream claim creation platform
• Proactively surface trade-offs (build vs. configure, performance vs. cost, scope vs. timeline) and guide the client to the right decision — trusted advisor, not order-taker

Key Skills

Education

Any Graduate