Full-Time

Solution Architect

Posted on 7/21/2025

Abacus Insights

Abacus Insights

201-500 employees

Cloud-based payer data integration platform

No salary listed

Remote in USA

Remote

Category
Sales & Solution Engineering (1)
Required Skills
Microsoft Azure
Product Management
AWS
Databricks
Snowflake
Google Cloud Platform
Requirements
  • Understanding and passion for healthcare data and systems – including payer, provider, and integration partners. Strong working knowledge of US healthcare data, including but not limited to Medical Claims, Pharmacy Claims, Membership / Enrollment, Provider and Clinical.
  • Domain expertise in CMS Interoperability Mandate (9115 / 0057) - including the technology used to serve the mandated APIs as well as the data structures (FHIR) required to be compliant.
  • Ability to define the solution architecture vision in architecture design documents
  • Broad and general technical knowledge as well as competencies in infrastructure, data models, databases, service orientation, programming, frameworks, standards, and technical modeling. Strong experience with one or more cloud vendors (AWS / Azure / GCP) and data platforms (Databricks / Snowflake) desired.
  • Strong understanding of healthcare industry trends, regulations, and customer needs with preference for previous payer / Interoperability vendor experience
  • Experience translating business needs into technology solutions that enable delivery of the Abacus platform.
  • Strong communicator who can leverage their domain and technical expertise effectively with the client and build working relationships with internal and external team members. Ability to communicate succinctly and clearly, both verbally and written, across technical and non-technical audiences at multiple levels, including business leaders.
  • Experience working in the payer / healthcare data space and understanding of the historical data architecture needs of our clients.
  • Understanding of client services or experience working for a cloud-based data management provider to large clients.
Responsibilities
  • Author the project architecture design documents, including data flows, sequence diagrams and overall system architecture, that will drive the technical implementation of the solutions. This role will primarily focus on defining solutions associated with CMS Interoperability, but may also work on other data solutions.
  • Work across business and IT teams to understand the current business and system capabilities and determine the desired state to define the overall technology strategy roadmap
  • Work closely with cross-functional teams, including business experts, technical business analysts, project managers, sales / account executives and data engineers to successfully implement client projects which reduce technology costs and solution redundancy.
  • Collaborate with Product Management to identify client-specific requirements that may translate into an existing standard product feature or a future feature on the Abacus product roadmap.
  • Define the solution architecture visions for designated components that describe the long-term goals as well as near-term needs of the client.
  • Provide mentorship to internal teams on business needs and use cases for seamless client implementation. Provide ongoing support to address questions and issues raised by the implementation team.
Desired Qualifications
  • Working knowledge of Provider (EHR) Data formats and topics – including FHIR, X-12, HL-7 V2.3, and CCDA/CDA - as well as the general system architecture required to consume and make use of this data.
  • Working knowledge of Utilization Management / Care Management / Disease Management.

Abacus Insights provides a cloud-based data transformation platform for health plans that ingests data from claims, clinical records, and member eligibility and consolidates it into a unified, usable data set. It creates a 360-degree view of the patient and serves as a data layer that decouples data from analytics tools, delivering secure, HIPAA-compliant data feeds tailored to specific business uses. The company differentiates itself with payer-specific data workflows, a focus on cleaning and unifying siloed data, and leadership with deep payer and clinical expertise, enabling health plans to use their preferred analytics tools. Its goal is to help health plans improve clinical outcomes, reduce costs, and enhance member experiences by providing high-quality, accessible data for decision making.

Company Size

201-500

Company Stage

Series D

Total Funding

$132.5M

Headquarters

Boston, Massachusetts

Founded

2017

Simplify Jobs

Simplify's Take

What believers are saying

  • Databricks partnership accelerates proprietary generative AI products for payer outcome improvements.
  • Tech Mahindra and ZS partnerships de-risk implementations and expand market reach at scale.
  • Stars Performance Data Solution directly addresses Medicare quality metrics driving payer ROI.

What critics are saying

  • CMS TEFCA mandate effective January 2026 commoditizes proprietary data transformation via QHIN networks.
  • Komodo Health's 330M-life Healthcare Map undercuts Abacus' 23M scale with price compression.
  • Optum's Change Healthcare acquisition captures Blue Cross partnerships through bundled claims dominance.

What makes Abacus Insights unique

  • Purpose-built cloud platform exclusively designed for health plan payer data transformation needs.
  • Manages data for 23 million U.S. health insurance members with 15-minute data delivery velocity.
  • Physician-founded by Dr. Minal Patel with deep payer operations and McKinsey consulting expertise.

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Benefits

Flexible Work Hours

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

-4%

2 year growth

-7%
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What Abacus Insights Inc. heard at HIMSS26: the payer perspective (3 key shifts). Manage Cookie Consent To provide the best experiences, Abacus Insights Inc. use technologies like cookies to store and/or access device information. Consenting to these technologies will allow Abacus Insights Inc. to process data such as browsing behavior or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions. Contact Us

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Tech Mahindra and Abacus Insights Partner to Simplify U.S. Healthcare Data Compliance

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Aug 22nd, 2024
Increase Medicare Star Ratings with Insights-Ready Data(TM) from Abacus Insights' Stars Performance Data Solution

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Digital Convergence Technologies
Mar 1st, 2023
Building a Secure Offshore Delivery Center for Healthcare Data Management

DCT partnered with Abacus Insights to build an offshore captive centre in Pune, India.

Business Wire
Nov 29th, 2022
Zs And Abacus Insights Partner To Bring Innovative Data And Analytics To Health Plans

EVANSTON, Ill. & BOSTON--(BUSINESS WIRE)--As ZS continues to help health plans evolve and transform, the firm announced today an investment in and partnership with Abacus Insights, a healthcare technology leader with a groundbreaking offering in data usability that rapidly accelerates the achievement of key health plan goals including efficiency, equity, health services and member outcomes. “At ZS, we believe the future of healthcare is connected, with providers, health plans, pharma companies and other stakeholders working together,” said ZS CEO Pratap Khedkar. “Usable data from Abacus Insights is a key enabler and connecter, and we take seriously our role in helping health plans innovate and excel. Partnerships like this one between ZS and Abacus Insights will be increasingly important in a connected health ecosystem.”

INACTIVE