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AI Lead/AI Architect with Health Insurance experience

Jobs via Dice, Bloomfield, Connecticut, us, 06002

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Job Title:

Lead AI Architect Healthcare & Cloud Platforms

Location:

Bloomfield CT - Hybrid

Experience Level:

13+ years

Role Overview We are seeking a highly experienced

Lead Architect

to drive enterprise-grade cloud Generative AI Platform initiatives in the

Healthcare Payer

and

PBM (Pharmacy Benefit Management)

space. This role demands a unique combination of technical leadership, domain knowledge, and client-facing communication skills. You will be instrumental in architecting and driving implementation of scalable, secure, and cost-optimized GenAI-powered systems and modern test automation pipelines using cloud services (AWS & Azure).

Key Responsibilities

Lead solution architecture and implementation for healthcare payer clients, with a focus on PBM systems, claims management, benefits configuration, and eligibility workflows.

Design cloud-native generative AI solution platforms on AWS and Azure with an emphasis on performance, scalability, resilience, and cost efficiency.

Serve as a strategic technical advisor in client engagements, translating business requirements into technical solutions.

Architect and drive implementation of GenAI-enabled systems, particularly RAG (Retrieval-Augmented Generation) patterns for knowledge-based services.

Collaborate with product, engineering, UX, and QA teams to embed UX-driven test automation frameworks using Python and JavaScript.

Understand architectural governance, standards, and best practices for multi-region, multi-cloud deployments.

Stay ahead of the curve on regulatory compliance in healthcare (HIPAA, HITRUST), data privacy, and security controls.

Required Skills and Competencies Domain Expertise:

Understanding of the Healthcare Payer ecosystem including claims adjudication, EDI workflows, member/provider systems, and payer-provider data exchange models.

Proven experience in PBM systems, including formulary management, prior authorization, and medication adherence workflows.

Cloud and Systems Architecture:

5+ years of experience in architecting solutions on AWS and/or Azure, with proficiency in IAM, EC2, Lambda, S3, ECS, RDS, Redshift (AWS) and App Services, Azure Functions, Cosmos DB, Azure DevOps (Azure).

Familiarity with cost modeling and optimization in cloud environments.

Strong foundation in microservices, event-driven architecture, and API management.

Software Engineering and Automation:

Hands-on expertise in Python and JavaScript for platform development and scripting.

Experience with modern test automation frameworks that are UX-focused (e.g., Cypress, Playwright).

Ability to drive the design of CI/CD pipelines and integration of quality assurance into release workflows.

Generative AI & Advanced Systems:

Strong knowledge of GenAI platforms, including RAG patterns, vector databases, prompt engineering, and LLM lifecycle management.

Understanding of how AI can be applied in clinical decision support, prior authorization automation, and member engagement.

Soft Skills:

Strong client-facing communication and stakeholder management capabilities.

Adept at cross-functional collaboration and leading matrix teams across technology, product, and business groups.

Thought leadership and mentoring of technical teams.

Preferred Qualifications:

Bachelor or Master degree in Computer Science, Engineering, or a related field.

AWS/Azure certifications (e.g., AWS Solutions Architect Professional, Azure Solutions Architect Expert).

Experience working with FHIR, HL7, EHR integrations, or healthcare interoperability frameworks.

Prior involvement in enterprise AI/ML strategy or innovation programs in healthcare.

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