Position Title: HRP Migration Architect Location: Remote, client location in Canton, MA preferred Start Date: 11/2/2026 Priority: Critical
Technical Skills
Application Integrator-EDI
Data Migration
Health Care Payers
Solutions Architecture
Position Description
Lead architect for the migration of a healthcare payer's core claims platform from a legacy claims engine to HealthEdge HealthRules Payer (HRP) as the target system. You own the target state architecture, migration strategy, and integration design from discovery through cutover and stabilization.
This position is located at the client site in Canton, MA but can be performed remotely.
Your future duties and responsibilities
Target state architecture: Define the HRP solution architecture across Member, Product/Benefit, Provider, Claims, and Financial modules, and keep it aligned with the enterprise architecture.
Migration strategy: Design the end to end approach, including data migration (extract, transform, load, reconcile), cutover options (big bang vs. phased/LOB wise), parallel runs, and rollback.
Legacy to HRP mapping: Lead gap/fit analysis and data mapping from legacy structures to HRP's data model. Resolve configuration vs. customization decisions.
Configuration oversight: Guide benefit plan, product, pricing/fee schedule, contract, accumulator, and adjudication rule configuration in HRP.
Integration and EDI design: Own the integration landscape around HRP: X12 transactions: 837 (P/I/D), 835, 834, 820, 270/271, 276/277, 278 Clearinghouse, enrollment, eligibility, and billing flows Downstream feeds: finance/GL, pharmacy (PBM), UM/care management, data warehouse, reporting APIs and event/messaging patterns, plus interoperability touchpoints (e.g., CMS 0057 API dependencies)
Data quality and reconciliation: Define migration validation, financial and claims reconciliation, and open claim/in flight transition rules.
Testing and readiness: Shape the QE strategy (system, integration, end to end, UAT, regression, performance). Define entry/exit criteria and go live readiness.
Governance and leadership: Act as technical authority with the client, HRP vendor, and delivery teams. Own design decisions, risk/issue management, and architecture review boards.
Stakeholder communication: Translate technical decisions for business, operations, and executive audiences.
Required qualifications to be successful in this role
10+ years in healthcare payer technology, with 5+ years of hands on HRP experience
Led at least 1 2 full core claims migrations to HRP (not just implementation or support)
Deep functional and technical knowledge of HRP modules: Member, Product, Provider, Claims, Financials
Strong command of HIPAA X12 EDI and how it maps to HRP inbound/outbound processing
Proven data migration experience at payer scale (conversion design, mapping, reconciliation, mock loads)
Solid understanding of claims adjudication, pricing, accumulators, COB, appeals, and payment/remit processes
Experience with integration patterns (APIs, MQ/ESB, ETL, batch vs. real time)
Familiarity with regulatory requirements (HIPAA, CMS, state mandates)
Strong executive level communication and client facing leadership
Preferred qualifications
HealthEdge certifications or direct HealthEdge partner/vendor experience
Experience with multiple LOBs (Commercial, Medicare Advantage, Medicaid, Exchange)
Exposure to cloud hosted HRP deployments and DevOps/CI CD for configuration promotion
Experience applying AI/automation to migration testing, mapping, or reconciliation
Background in payer mergers or multi entity platform consolidations
Education: Bachelor's degree in computer science or similar field.
Numbers & Facts
Location
Canton, MA (Remote)
Industry
Computer Software
Company Size
100 to 499 employees
Skills
Acceptance Testingunmatched
Adjudicationunmatched
Application Programming Interface (API)unmatched
Artificial Intelligence (AI)unmatched
Billingunmatched
Business Operationsunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Computer Scienceunmatched
Content Management Systems (CMS)unmatched
Customer Relationsunmatched
Data Mappingunmatched
Data Migrationunmatched
Data Modelingunmatched
Data Qualityunmatched
Data Warehousingunmatched
Database Extract Transform and Load (ETL)unmatched
Electronic Data Interchange (EDI)unmatched
Enterprise Architectureunmatched
Enterprise Service Bus (ESB)unmatched
Fee Scheduleunmatched
Financeunmatched
Gap Analysisunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Healthcareunmatched
Interoperabilityunmatched
Leadershipunmatched
Medicaidunmatched
Medicareunmatched
Messaging Middlewareunmatched
Microsoft Exchange Serverunmatched
Migration Strategyunmatched
Pharmacyunmatched
Pricingunmatched
Product Planningunmatched
Product Pricingunmatched
Reconciliationunmatched
Regulatory Requirementsunmatched
Risk Managementunmatched
System Integration (SI)unmatched
Test Automationunmatched
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