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Role Description

Responsible for providing expert solution knowledge, recommended implementation and maintenance best practices, and process design representing their domain of expertise.

The Business Solution Architect serves as the primary lead responsible for designing, implementing, and optimizing end-to-end business solutions across healthcare organizations. This role owns the overall solution design and architecture, supporting the full lifecycle from patient registration and access through revenue cycle operations, billing, remittance, and financial reporting. The Business Solution Architect oversees these functions throughout the implementation lifecycle, with a strong emphasis on behavioral health and public sector environments.

Partnering closely with clients, this role evaluates current state workflows, leads solution design decisions, drives data collection and workflow analysis, and recommends industry-aligned best practices to deliver scalable solutions that support operational efficiency, compliance, and accurate financial outcomes.

Leveraging deep experience in billing system implementations, including Medicaid/Medi-Cal, Medicare, Managed Care, and California DHCS regulated workflows, the Business Solution Architect provides hands-on leadership across credentialing, enrollments, eligibility, scheduling, claims, remittance, accounts receivable, and downstream financial reporting. As the key solution lead, the Financial Solution Architect acts as a trusted advisor for complex troubleshooting and issue resolution, manages client expectations, and coaches solution teams to ensure consistent methodology, high-quality delivery, and successful client outcomes.

• Provide expertise during client engagement to deliver workflow and solution design to achieve defined benefits.
• Responsible for guiding clients through current workflows, upgrades, system changes, enhancements, and ongoing system maintenance while considering other system integration points.
• Critically assess client workflows and identify opportunities for integration with other solutions and potential pitfalls.
• Act as a primary consultant for the client’s solution troubleshooting, consultation, and knowledge transfer.
• Accountable for relationships with clients to provide appropriate escalation of issues, solution knowledge, and engagement support.
• Proactively seek to resolve escalated problems and issues using solution knowledge and expertise during installation, operation, maintenance, or testing.
• Manage client expectations and ensure project delivery meets goals of engagement.
• Coach, mentor and guide solution teams and new associates on recommended methodology practices and roles.

Qualifications

• Bachelor's degree or equivalent relevant work experience.
• At least 4 years of health care information technology implementation or consulting working experience.
• At least 2 years Netsmart EHR solution work experience.
• At least 1 year of project management experience.
• Ability to communicate effectively with technical, clinical, and operational teams.
• Ability to document and present architecture concepts, often narrowing complex ideas to a single overview.
• Ability to build strong client relationships and deliver client-centric solutions.
• Ability to make sense of complex, high quantity and sometimes contradictory information to effectively solve problems.

Requirements

• At least 2 years Netsmart EHR solution work experience (myAvatar).
• Experience with billing system implementations, ideally within healthcare or behavioral health environments.
• California healthcare billing experience, including Medi-Cal and county or state-level programs.
• Proficiency in CPT/HCPCS coding for behavioral health, including inpatient and outpatient services.
• Hands-on experience with 837P/837I claims, UB-04 formatting, and clearinghouse workflows.
• Familiarity with California DHCS requirements, including eligibility transactions (270/271) and claims submission.
• Skilled in remittance processing, 835 interpretation, and denial management.
• Strong accounts receivable (A/R) knowledge, including aging, reconciliation, and follow-up strategies.
• Experience with Medicaid and Medicare billing, including Managed Care Organizations (MCOs).
• Understanding of healthcare reimbursement models, including fee-for-service, case rates, DRG, and value-based models.
• Experience supporting or collaborating on county, public-sector, or state healthcare implementations.
• Collaborative approach to aligning billing workflows with clinical documentation and compliance requirements.
• Experience with EHR billing platforms (e.g., myAvatar, myEvolv or similar systems) is a plus.
• Experience with end-to-end workflows supporting patient registration, revenue cycle, and financial reporting.

Expectations

• Travel expected up to 20% of the time as needed.
• Position may at times require extended or irregular hours outside of traditional office hours to support clients and projects across multiple time zones and any required travel.