Lead Director – Solutions Architect, Epic Applications

Job Description:

  • Own end-to-end solutions architecture for Epic Healthy Planet, care coordination workflows, and STARS/HEDIS/quality measure reporting
  • Design scalable data models and workflows connecting Epic Clarity/Caboodle, Healthy Planet registries, care management, and risk stratification tools
  • Serve as technical authority on Epic’s population health suite and integrations with clinical, claims, and payer data sources
  • Partner with enterprise architecture and data teams on data governance, FHIR/HL7 interoperability, and analytics strategy
  • Evaluate and recommend build-versus-buy decisions for third-party STARS/quality vendors
  • Lead design and optimization of Epic workflows supporting CMS Star Ratings, HEDIS measures, and quality gap closure
  • Ensure Epic build supports care gap identification, outreach workflows, and measure-specific documentation
  • Translate NCQA and CMS regulatory measure specifications into Epic build requirements
  • Oversee Reporting Workbench, SlicerDicer, and Clarity/Caboodle-based reporting architecture
  • Architect and oversee care management workflows, including registries, care plans, risk stratification, transitions of care, and care team communication
  • Ensure Healthy Planet configuration supports ACO, Medicare Advantage, and population health programs
  • Drive integration between Healthy Planet and external care coordination platforms, HIEs, and payer systems
  • Lead and mentor Epic analysts, architects, and/or engineers
  • Partner with clinical, quality, compliance, and network/ACO leadership on the technical roadmap
  • Present architecture decisions, risks, and roadmap to senior IT and business leadership
  • Participate in Epic governance, upgrade planning, and enterprise architecture review boards
  • Manage vendors related to STARS/quality reporting tools and population health platforms

Requirements:

  • Bachelor's degree in Computer Science, Health Informatics, Information Systems, or related field
  • 10+ years of healthcare IT experience
  • 5+ years focused on Epic applications
  • Deep hands-on or architectural experience with Epic Healthy Planet, Care Everywhere, and/or population health modules
  • Strong understanding of CMS STARS methodology, HEDIS measures, and quality/risk adjustment reporting requirements
  • Experience architecting solutions involving Clarity, Caboodle, and/or Epic reporting tools
  • Proven track record leading enterprise-scale Epic initiatives and managing technical teams
  • Strong understanding of value-based care, ACO operations, and payer-provider data exchange
  • Master's degree preferred
  • Epic certification(s) in Healthy Planet, Ambulatory, or related modules preferred
  • Experience with FHIR/HL7 interoperability standards and payer data integration preferred
  • Background working within an integrated payer-provider organization or ACO preferred
  • Experience with Medicare Advantage plan operations preferred
  • Advanced degree or certifications in health informatics, data architecture, or population health preferred
  • Ability to translate complex regulatory/quality requirements into practical technical architecture
  • Strong executive presence and ability to communicate technical trade-offs to non-technical leadership
  • Ability to balance long-term architectural vision with near-term delivery pressures
  • Skilled at leading cross-functional teams spanning clinical, quality, compliance, and IT

Benefits:

  • CVS Health bonus, commission or short-term incentive program
  • Award target in the company’s equity award program
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources supporting physical, emotional, and financial well-being
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