Enterprise Data Architect

Posted 2 Days Ago
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The Center, IN, USA
In-Office
130K-195K Annually
Expert/Leader
Healthtech • Database
The Role
Designs and governs enterprise data architecture for a Medicare Advantage health plan. Builds data models and integrations supporting claims, EHRs, risk adjustment, HEDIS, Star ratings, CMS reporting, analytics, and AI/ML. Establishes governance, security, privacy, lineage, and data quality frameworks for regulated PHI/PII environments. Evaluates cloud platforms and vendors, leads cross-functional architecture initiatives, and advances capabilities such as FHIR interoperability, generative AI, and real-time streaming.
Summary Generated by Built In

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Enterprise Data Architect sets the technical foundation for how data is structured, integrated, stored and governed across our Medicare Advantage health plan — translating business strategy into scalable, compliant, and future-ready data solutions/services. This role partners directly with clinical operations, actuarial, compliance, IT, and business intelligence teams to ensure data assets support accurate risk adjustment, Star ratings performance, regulatory reporting, and member outcomes. The position drives measurable impact on the organization's ability to use data as a strategic asset — enabling analytics, AI/ML capabilities, and CMS-compliant reporting at scale.

Job Duties/Responsibilities 

Design and govern the data architecture that spans operational systems, cloud platforms, and analytics environments to support clinical and business workflows across our Medicare Advantage lines of business. 

Build and maintain data models (conceptual, logical, and physical) that enable accurate risk adjustment, HEDIS reporting, Star ratings optimization, and encounter data submissions to CMS. 

Establish and enforce data governance frameworks — in coordination with the Data Governance, compliance, and privacy teams — covering data quality, lineage, PHI/PII classification, and audit readiness. 

Integrate structured and unstructured data from claims systems, EHRs, pharmacy platforms, and third-party sources into unified, reliable data pipelines that serve analytics and operational decision-making. 

Define and uphold security architecture that meets HIPAA, CMS, and SOC 2 requirements while enabling appropriate, governed access for analytics teams and business consumers. 

Evaluate and recommend data platforms, cloud technologies, and vendors — including tools for data virtualization, orchestration, consumption, analytics and AI/ML infrastructure — that align with organizational strategy and roadmap priorities. 

Serve as the primary technical data partner to cross-functional leaders across clinical operations, population health, finance, product, and compliance — translating complex architecture decisions into clear business context. 

Advance data-enabled innovation by scoping and piloting emerging capabilities — including generative AI, FHIR-based interoperability, and real-time streaming — that support care management and member engagement initiatives. 

 

Supervisory Responsibilities 

This role does not carry direct supervisory responsibility. The Enterprise Data Architect leads through technical authority and cross-functional influence across engineering, analytics, governance, and business teams. 

 

Job Requirements 

Experience 

Required: 

  • 10+ years of progressive experience in data architecture, enterprise data integration, and database design 

  • Minimum 2 years of experience working in a health plan, payer, or healthcare delivery system with direct familiarity with claims data, EHRs, HEDIS, and CMS reporting environments 

  • Demonstrated experience designing data platforms in regulated, audit-sensitive environments with PHI and PII datasets (including canonical models for Enterprise Data Platforms) 

  • Proven experience with cloud data platforms (AWS, Azure, or GCP) and modern architecture patterns including data lakes, lakehouses, and real-time streaming 

  • Experience leading cross-functional architecture initiatives and influencing senior stakeholders without direct authority 

  • Experience with working in agile delivery model. 

Preferred: 

  • Experience designing data solutions for Medicare Advantage-specific programs including risk adjustment, Star ratings, RADV audits, and value-based care models 

  • Experience enabling AI/ML and generative AI capabilities within a healthcare data platform context 

  • Background in DataOps, Agile delivery methodologies, and healthcare interoperability standards (FHIR, HL7) 

 

Education 

Required: 

  • Bachelor's degree in Computer Science, Information Systems, Data Science, Engineering, or a related technical field; equivalent combination of education and demonstrated experience will be considered 

Preferred: 

  • Master's degree in a related technical or data discipline 

 

Training 

Required: 

  • Demonstrated working proficiency with cloud data platforms (Azure Databricks, Snowflake, BigQuery, Redshift, or equivalent) acquired through direct hands-on project experience 

Preferred: 

  • Cloud platform certification (AWS Certified Data Analytics, Azure Data Engineer Associate, or Google Professional Data Engineer) 

  • Data governance or architecture certification (TOGAF, DAMA-CDMP) 

 

Skills & Competencies 

Technical / Role-Specific Skills 

  • Data Architecture & Modeling — Expert-level proficiency in conceptual, logical, and physical data modeling using industry methodologies (Kimball, Inmon, Data Vault). 

  • Cloud Data Platforms — Hands-on experience with Snowflake, Databricks, BigQuery, or Redshift; familiarity with data lake and lakehouse architectures. 

  • Data Integration & Orchestration — Working knowledge of ETL/ELT tools and orchestration platforms (Informatica, Talend, dbt, Airflow). 

  • Healthcare Data Standards & Regulatory Knowledge — Applied knowledge of Medicare Advantage data constructs including HIPAA, CMS encounter data, HEDIS, STAR ratings, risk adjustment (HCC coding), and ICD-10/CPT codes. 

  • Data Governance & Security — Demonstrated ability to design and enforce governance frameworks, data classification, lineage tracking, and PHI/PII protection across regulated environments. 

  • SQL & Programming — Advanced SQL proficiency; working knowledge of Python or Scala for data engineering and pipeline use cases. 

  • AI/ML-Enabling Infrastructure — Familiarity with MLflow, Feature Store, vector databases, LangChain, and generative AI APIs in the context of healthcare data environments. 

 

Licensure 

Required: 

  • None required for this role. 

Preferred: 

  • TOGAF (The Open Group Architecture Framework) 

  • DAMA Certified Data Management Professional (CDMP) 

  • AWS Certified Data Analytics, Azure Solutions Architect, or Google Professional Cloud Architect 

  • CPHIMS (Certified Professional in Health Informatics and Information Management) or equivalent healthcare IT credential 

 

Essential Physical Functions 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. 

  • While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 

  • The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. 

Pay Range: $130,332.00 - $195,498.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].

Skills Required

  • 10+ years of progressive experience in data architecture, enterprise data integration, and database design
  • At least 2 years of experience in a health plan, payer, or healthcare delivery system, including claims data, EHRs, HEDIS, and CMS reporting
  • Experience designing data platforms in regulated, audit-sensitive environments using PHI and PII datasets
  • Experience developing canonical models for enterprise data platforms
  • Experience with AWS, Azure, or GCP and modern data architecture patterns including data lakes, lakehouses, and real-time streaming
  • Experience leading cross-functional architecture initiatives and influencing senior stakeholders without direct authority
  • Experience working in an agile delivery model
  • Bachelor's degree in Computer Science, Information Systems, Data Science, Engineering, or a related technical field, or equivalent education and experience
  • Hands-on proficiency with Azure Databricks, Snowflake, BigQuery, Redshift, or equivalent cloud data platforms
  • Expert proficiency in conceptual, logical, and physical data modeling using Kimball, Inmon, or Data Vault methodologies
  • Experience with data lake and lakehouse architectures
  • Working knowledge of ETL/ELT and orchestration tools such as Informatica, Talend, dbt, or Airflow
  • Applied knowledge of Medicare Advantage data, HIPAA, CMS encounter data, HEDIS, Star ratings, risk adjustment, HCC coding, and ICD-10/CPT codes
  • Experience designing data governance, classification, lineage, and PHI/PII protection frameworks
  • Advanced SQL proficiency and working knowledge of Python or Scala
  • Experience designing Medicare Advantage solutions involving risk adjustment, Star ratings, RADV audits, or value-based care
  • Experience enabling AI/ML and generative AI capabilities in healthcare data platforms
  • Background in DataOps, agile delivery methodologies, FHIR, and HL7
  • Master's degree in a related technical or data discipline
  • Cloud platform certification such as AWS Certified Data Analytics, Azure Data Engineer Associate, or Google Professional Data Engineer
  • Data governance or architecture certification such as TOGAF or DAMA-CDMP
  • Healthcare IT credential such as CPHIMS or equivalent

Alignment Healthcare Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Alignment Healthcare and has not been reviewed or approved by Alignment Healthcare.

  • Healthcare Strength — Core coverage includes multiple medical plan types with major carriers along with dental and vision. Options are described as comprehensive on paper and can include plan choice depending on role and location.
  • Retirement Support — A 401(k) plan with company match is commonly offered, and some roles also receive equity via RSUs. This foundation strengthens total rewards even when base pay varies by job family.
  • Leave & Time Off Breadth — PTO is offered with paid holidays, and some teams provide paid parental leave; clinical roles may include CME time and tuition reimbursement. These elements expand beyond basic medical benefits to support time away and professional development.

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The Company
HQ: Orange, CA
749 Employees
Year Founded: 2013

What We Do

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers health plan options through Alignment Health Plan, and also partners with select health plans to help deliver better benefits at lower costs. For more information, please visit www.alignmenthealthcare.com.

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