Business Solution Architect (Consulting)

About the Role

At Netsmart, improving care delivery is our passion. For over 50 years, we’ve been a healthcare software company developing technology and services for the behavioral health, human services, and Post-Acute markets. We collaborate with organizations across the care spectrum to anticipate challenges, identify obstacles, and recognize new opportunities as healthcare evolves.

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, 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.

Responsibilities

• Provide expertise during client engagement to deliver workflow and solution design to achieve defined benefits.
• Guide 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.
• Manage client relationships to provide appropriate escalation of issues, solution knowledge, and engagement support.
• Proactively 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.
• Leverage deep experience in billing system implementations, including Medicaid/Medi-Cal, Medicare, Managed Care, and California DHCS regulated workflows, to provide hands-on leadership across credentialing, enrollments, eligibility, scheduling, claims, remittance, accounts receivable, and downstream financial reporting.
• Act as a trusted advisor for complex troubleshooting and issue resolution.

Requirements

• Bachelor's degree or equivalent relevant work experience.
• At least 4 years of healthcare information technology implementation or consulting experience.
• At least 2 years of 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, simplifying complex ideas into clear overviews.
• Ability to build strong client relationships and deliver client-centric solutions.
• Ability to analyze complex, high-quantity, and sometimes contradictory information to solve problems effectively.

Preferred Qualifications

• At least 2 years of 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).
• Experience with end-to-end workflows supporting patient registration, revenue cycle, and financial reporting.

Schedule

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