Company Description OnSure Health LLC focuses on end-to-end Revenue Cycle Management solutions for healthcare organizations, combining technology, AI, and automation to simplify complex workflows. The company’s services span medical coding, accounts receivable and denials management, front-office staffing solutions, and scribe support. OnSure Health also offers IT consulting to optimize healthcare operations and system performance.

In addition, the organization provides bad debt collection services to help clients improve financial outcomes and operational efficiency.

Role Description The Lead Technical Architect is a full-time, on-site role based in New Delhi, responsible for designing and overseeing scalable technical solutions that support OnSure Health’s Revenue Cycle Management and healthcare technology offerings. This role involves defining the overall technical architecture, leading solution design, and ensuring robust integration between internal platforms, third-party systems, and client environments.

The Lead Technical

Architect will collaborate with software development teams to translate business requirements into technical specifications, guide implementation, and maintain alignment with enterprise architecture standards. Daily activities include reviewing and optimizing system performance, managing technical risks, conducting architecture reviews, and providing technical leadership to cross-functional teams. The role also entails working closely with product, operations, and IT consulting teams to ensure solutions are secure, compliant, and aligned with industry best practices.

Qualifications

Experience

8–12+ years; exceptional 5–8 year candidates may be considered

Location / Work Model





Delhi-NCR hybrid strongly preferred

Role Type

Phase-1 founding engineering team

Role Mission

Founding technical owner for an AI-native ambulatory EHR for small and independent US medical practices. Translate product and clinical requirements into secure, scalable, maintainable architecture while remaining actively involved in implementation. This is not a documentation-only architect role.

Key Responsibilities

Own Phase-1 application/solution architecture and translate the modular-monolith/service-oriented approach into enforceable module boundaries.

Define backend, API, persistence, integration, multi-tenancy, authentication/authorization, RBAC, audit, PHI-security, and engineering conventions.

Guide clinical-domain modeling, longitudinal data, terminology/coding, orders/results, documentation, and clinical-to-billing handoff architecture.

Define replaceable integration patterns for labs, ePrescribing, clearinghouses, eligibility, payments, communications, and future FHIR/HL7 workflows.

Define AI orchestration, structured-output validation, human review, provenance, PHI controls, provider abstraction, fallbacks, evaluation, and cost/latency considerations.

Own cloud/environment/CI-CD/security direction during the initial lean phase; establish IaC, secrets, observability, backup/recovery conventions.

Conduct architecture and code reviews, mentor engineers,



participate directly in critical implementation, and make pragmatic build-vs-buy decisions.

Prevent unnecessary infrastructure complexity and premature microservices.

Must-Have Capabilities

Strong recent hands-on production SaaS engineering and architecture ownership.

Robust hands-on expertise with at least one modern enterprise backend platform (Java/Spring Boot, ASP.NET Core, or Node.js/NestJS), RESTful API architecture, relational databases (PostgreSQL preferred), cloud platforms (Azure preferred), containerization (Docker), CI/CD, observability, security, and third-party integrations.

Ability to reason about data lifecycle, historical integrity, failure modes, concurrency, idempotency, and production operations.

Demonstrated code review and technical mentorship.

Ability to quickly learn and work within AIdentive.AI’s selected technology stack. Demonstrated engineering fundamentals are considered more important than prior experience with any specific framework.

Preferred / Good to Have

Healthcare/EHR/EMR, HIPAA, FHIR/HL7, clinical terminology, RCM/billing, multi-tenant B2B SaaS, integration-heavy platforms, LLM/AI application architecture.

Kubernetes

Terraform/Bicep

Infrastructure as Code

Azure AI/OpenAI

Event-driven architecture

First Six-Month Outcomes

Production-quality engineering foundation and enforceable architecture.

Secure tenant/access-control and clinical-data foundations.

Integration and AI application architecture with human-review/provenance patterns.

Automated engineering/deployment/observability foundations.

Architectural runway for later specialties, RCM, interoperability, and scale.

📌 Lead Technical Architect (New Delhi)
🏢 OnSure Health
📍 New Delhi