Remote Work From Home Health Insurance Tpa Jobs (NOW HIRING)

Role: Technical Architect Data Platform
Location: REMOTE / Work From Home
Contract Role
Job description:
We are hiring 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.
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.
Skills & Experience:

• 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
• Tech Stack - MS Fabric (OneLake, Data Factory, Lakehouses, Delta Lake), Azure Document Intelligence, Microsoft Purview, Okta SSO, Python, SQL, Azure AI Services, Azure DevOps, Git and WinAIDM (Ingestion / Quality / Transformation / Reporter Agents - preferred)
• 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

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 WinWire'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
What Success Looks Like / Expected outcome - OneLake medallion architecture fully operational for five Phase 1 TPAs - Bronze immutable history, Silver canonical current state, Gold curated views consumed by the client's claim creation team before go-live. AI-assisted schema registry live and handling format drift across all Phase 1 TPA variants without manual intervention; Intake control layer operational with documented DQ rules per TPA, failed files routed to review queue with structured reason codes; A successful implementation of Phase I and II of Claims Management Platform. WinAIDM accelerators deployed and driving measurable reduction in pipeline development and validation effort across the team. Client technology stakeholders describe WinWire as a "trusted architecture guide" - proactive, decision-ready, and commercially aligned
Why Join Us - Own a CEO-prioritized platform: Architect a mission-critical production claims system from blank canvas - not a prototype, not a PoC; Microsoft Fabric at enterprise scale: Rare hands-on opportunity designing a complex medallion Lakehouse for high-volume insurance claims processing - a differentiated skill set in the market; AI-augmented delivery: Work with WinWire's proprietary WinAIDM platform and Azure AI Services - where architecture meets modern AI engineering; High-visibility trajectory: This role is the technical face of the engagement - direct path to Principal Architect and delivery leadership within WinWire; WinWire's people-first culture: Microsoft Partner of the Year (2025), Great Place to Work certified, 19+ years of enterprise delivery excellence across 100+ global clients.