Remote Risk Adjustment Coder Jobs in Texas (NOW HIRING)

Req ID: 375005 

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a AI Solutions Architect for Healthcare Payer and Life Science to join our team in Plano, Texas (US-TX), United States (US).

 AI Solution Architect for Healthcare Payer Segment

About the Role

We are seeking an experienced AI Solutions Architect to design and deliver artificial intelligence, machine learning, and generative AI solutions for health plan clients. This role will partner with payer executives, data leaders, and engineering teams to translate business challenges into scalable AI solutions.

The ideal candidate has deep knowledge of health plan operations, payer data ecosystems, cloud architecture, analytics platforms, and responsible AI practices. This person will lead solution design across areas such as member engagement, care management, utilization management, claims operations, risk adjustment, Stars, quality, provider network optimization, and administrative automation.

Location:  Remote role to be located in the US

If you are a proven AI leader with deep healthcare Payer expertise-and a passion for transforming healthcare through technology-this is an opportunity to shape the future of our business.  Work with our Payer AI leader, business leaders and clients discussing current state while looking at future state and bring forth technology solution ideas using AI capabilities.

What You'll Do

• Design end-to-end AI and generative AI solutions for health plan use cases, including architecture, data flows, integration patterns, model selection, governance, security, and deployment approach.
• Partner with health plan stakeholders to identify high-value AI opportunities, define business outcomes, assess feasibility, and shape implementation roadmaps.
• Lead solutioning for payer-specific domains such as claims, enrollment, benefits, prior authorization, medical management, provider data, quality measures, risk adjustment, member services, and regulatory reporting.
• Develop reference architectures using cloud platforms, data lakes, warehouses, MLOps pipelines, APIs, workflow tools, and enterprise integration patterns.
• Guide teams on applying large language models, retrieval-augmented generation, predictive analytics, natural language processing, intelligent automation, and decision support in healthcare settings.
• Collaborate with data scientists, engineers, clinicians, compliance teams, security architects, and delivery leaders to move concepts from prototype to production.
• Define responsible AI controls, including model monitoring, explainability, human-in-the-loop review, bias assessment, auditability, privacy, and regulatory compliance.
• Support pre-sales and client advisory activities, including solution presentations, proposals, estimates, demos, workshops, and executive briefings.
• Evaluate vendor platforms and AI tools across cloud, payer technology, data management, workflow automation, and clinical operations ecosystems.
• Create reusable assets, including solution blueprints, architecture patterns, implementation playbooks, data requirements, and governance frameworks.

• Strengthen alliances with key partners (Epic, Oracle Health, Microsoft, AWS, ServiceNow, cybersecurity vendors, Google, Leading AI players).
• Build and mentor a high-performing team of AI leaders.
• Develop sales collateral for all solutions and services catering to healthcare payers.

What We're Looking For

• Bachelor's degree in computer science, information systems, engineering, data science, healthcare informatics, or a related field.
• 8+ years of experience in technology architecture, data architecture, analytics, AI/ML, or enterprise solution delivery.
• 4+ years of experience supporting health plans, payers, managed care organizations, or healthcare administrative platforms.
• Hands-on experience designing AI, machine learning, generative AI, analytics, or automation solutions in production environments.
• Strong understanding of health plan business processes, including claims, membership, provider, utilization management, care management, quality, risk adjustment, and customer service.
• Experience with healthcare data standards and regulations, such as HIPAA, FHIR, HL7, X12 EDI, CMS interoperability requirements, and payer data exchange.
• Experience with major cloud platforms such as AWS, Azure, or Google Cloud, including data, AI, security, and integration services.
• Familiarity with modern AI patterns such as RAG, vector databases, prompt engineering, model evaluation, MLOps, LLMOps, and AI governance.
• Ability to communicate complex technical concepts to executive, clinical, operational, and technical audiences.
• Strong consulting, facilitation, problem-solving, and stakeholder management skills.

Required Qualifications:

• 8+ years of experience in designing and developing AI/ML solutions
• 4+ years of experience in healthcare Payer technology, consulting, or systems integration.

About NTT DATA

NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. our consulting and Industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.

Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client's needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, https://us.nttdata.com/en/contact-us.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is $119,578 - $221,625. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. 

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life and AD&D insurance, short and long term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.

NTT DATA endeavors to make https://us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https://us.nttdata.com/en/contact-us. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here. If you'd like more information on your EEO rights under the law, please click here. For Pay Transparency information, please click here.