POSITION SUMMARY
The Lead PACS Administrator / Imaging Informaticist / Enterprise Imaging Architect (the "Lead") is the senior technical authority for the health system's enterprise imaging environment and the technical leader of the imaging informatics staff. Beyond the design and hands-on scope of a senior architect, the Lead sets architecture standards, arbitrates the hardest technical decisions, owns the end-to-end technical plan for the Visage PACS and VNA migration, and serves as the standing technical liaison to the contracted radiology group and to the network, desktop/endpoint, and application teams. The Lead provides technical direction and mentorship to architects, analysts, and PACS administrators, and is the deepest technical escalation point below the Director. This is a working leadership role: most of the Lead's time is hands-on architecture and problem-solving, with the added responsibility of raising the whole team's technical bar and making cross-entity coordination actually function.

TECHNICAL ENVIRONMENT OF ROLE
EHR: Oracle Health (Cerner) Millennium. Radiology: migrating from the incumbent PACS to Visage 7 for PACS, enterprise viewing, and VNA. Cardiology: Fujifilm Synapse for cardiovascular PACS and VNA. Service lines supported include inpatient and outpatient radiology, cardiology, interventional radiology (IR), and a cardiac cath lab, across the hospital and the medical office building (MOB). Study volume is high, driven by a busy emergency department and the imaging needs of underserved communities, so imaging systems are effectively always in use and downtime tolerance is low.
Reading workflow adds real complexity. Diagnostic radiology is provided by a contracted radiology group from another health system. That partner operates its own network segment, its own reading workstations, and its own instance of the reading and worklist tools (Visage and Medicalis) inside our facilities. Study routing, worklist orchestration, and report return therefore cross an organizational boundary this role does not fully control. When the partner changes its desktop image, its Visage instance, or its Medicalis configuration, the effect can surface as a problem on our side, and resolution requires coordinated troubleshooting across two organizations and across our own network, desktop, and application teams. Supporting the Visage radiology migration through cutover and stabilization is a near-term priority.
CROSS-TEAM AND CROSS-ENTITY COLLABORATION
Because the imaging environment spans two organizations and several internal teams, the Lead is accountable for making cross-entity, cross-team coordination work in practice. The Lead owns the documented demarcation between our systems and the partner's, runs structured incident command when imaging is affected, and is the person other teams and the partner call first. The Lead sets the standards, runbooks, and change-review practices that keep a change on one side from silently breaking the other and builds the durable relationships across the contracted radiology group and the network, desktop, and applications teams that let fixes happen fast when no single team owns the whole problem. This leadership of collaboration, more than any single technology, is the defining feature of the role and is weighted heavily in selection.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Serve as the senior technical authority for enterprise imaging, setting architecture standards, design patterns, configuration baselines, and technical decision criteria across Visage, Fuji Synapse, and related imaging platforms.
• Lead enterprise imaging technical solutions across inpatient and outpatient radiology, cardiology, nuclear medicine, interventional radiology, visible light imaging where applicable, and the cardiac cath lab, including procedural, hemodynamic, archive, image exchange, image sharing, and long-term retention workflows.
• Own and lead the end-to-end technical plan for the Visage 7 PACS and VNA migration, including migration validation, interface design, cutover and rollback strategy, technical work coordination, and post-go-live stabilization.
• Provide technical direction, design review, and mentorship to PACS architects, imaging informatics analysts, and PACS administrators; grow team capability and reduce single points of failure.
• Serve as the primary technical liaison to the contracted radiology group's IT team for study routing, worklist orchestration, report return, and clear operational demarcation between environments.
• Lead cross-team and cross-organization incident command when imaging is affected, coordinating network, desktop/endpoint, application, vendor, and partner teams through root cause analysis, corrective action, and follow-through.
• Own imaging integration architecture with Cerner Millennium and related systems, including HL7 v2, DICOM, DICOMweb, IHE profiles, modality worklist, RIS/worklist tools, VNA, image exchange platforms, third-party viewers, cloud or hybrid imaging platforms, and AI imaging applications.
• Ensure imaging systems are engineered for high availability, throughput, and clinical reliability given heavy emergency department, outpatient, IR, and cath lab volume; treat downtime and performance degradation as clinical risks.
• Own imaging data lifecycle and archive strategy across Visage and Fuji, including retention, purge rules, routing, prefetch, compression standards, archive growth forecasting, and long-term storage planning.
• Establish and maintain imaging documentation, architecture diagrams, interface inventories, runbooks, change-review discipline, disaster recovery practices, and business continuity procedures.
• Evaluate imaging AI tools for technical fit, integration path, monitoring requirements, and performance drift in partnership with the organization's AI governance process.
• Represent the Director on technical matters and serve as imaging's voice in enterprise architecture, security, and change-advisory forums.
• Partner with contracted radiologists, cardiologists, IR and cath lab teams, technologists, and department leaders to translate clinical requirements into reliable imaging system design and workflow improvements.
• Serve as Tier III support and senior escalation for complex imaging system incidents, including image routing failures, missing studies, patient merge/split issues, HL7 interface failures, DICOM communication errors, modality connectivity issues, performance bottlenecks, disaster recovery events, and cross-team incidents.
• Enforce imaging system security and compliance in partnership with information security, including HIPAA requirements, access controls, audit logging, network segmentation for modalities, vendor remote access, cybersecurity initiatives, disaster recovery planning, and support for Joint Commission and other regulatory audits.
• Manage vendor technical relationships, hold vendors accountable to SLAs, and review proposed changes before they reach production.
• Participate in rotating on-call support for 24/7 hospital imaging operations, occasional evening or weekend maintenance windows, and emergency response activities when imaging availability, routing, reporting, or clinical operations are affected.

POSITION REQUIREMENTS

A. Education

• Bachelor's degree in health informatics, computer science, radiologic sciences, or a related field, or equivalent experience.
• Ten or more years of PACS administration, imaging informatics, or enterprise imaging experience in a hospital environment, preferably including multi-site or high-volume imaging operations; seven or more years may be considered with strong enterprise architecture, migration, and senior escalation experience.
• Deep working knowledge of DICOM, HL7, and IHE profiles, including DICOM storage, query/retrieve, modality worklist, MPPS, structured reports, DICOM routing, and HL7 ADT, ORM, ORU, and SIU messages between PACS/VNA, RIS/worklist tools, modalities, and an enterprise EHR.
• Hands-on Cerner (Oracle Health) imaging integration experience, including orders, results, and worklist flow.
• Experience leading or substantially contributing to at least one major PACS or VNA migration or enterprise imaging consolidation.
• Experience integrating or supporting imaging workflow across an organizational boundary (for example, a contracted or teleradiology reading group), or clear ability to do so.
• Demonstrated success leading cross-team troubleshooting across network, desktop/endpoint, and application groups, and comfort coordinating with an external partner's IT staff during incidents.
• Working knowledge of infrastructure technologies that support imaging systems, including Windows Server, Linux, VMware or other virtual environments, SAN/NAS storage, Microsoft SQL Server or Oracle databases, Active Directory, DNS, TCP/IP networking, VPN, firewalls, storage tiering, bandwidth planning, and DICOM routing, enough to work effectively with dedicated infrastructure, network, security, and desktop teams.
• Demonstrated ability to work directly with physicians and clinical staff and to translate between clinical and technical audiences.
• Demonstrated ability to maintain HIPAA-compliant imaging workflows, audit logging, access controls, disaster recovery procedures, business continuity testing, and support for Joint Commission or other regulatory audit activities.

B. Qualifications/Experience

• Direct experience with Fujifilm Synapse Cardiovascular (CVIS) or another cardiology PACS.
• Preferred experience with Visage 7 (PACS, enterprise viewer, or Open Archive VNA), especially a migration to Visage, a plus.
• Preferred experience with enterprise PACS and imaging platforms such as GE Healthcare, Philips IntelliSpace, Agfa Enterprise Imaging, Fujifilm Synapse, Sectra, Merge Healthcare, or similar systems.
• Preferred experience with Orthanc, DCM4CHEE, Mirth Connect or similar interface engines, SQL scripting, PowerShell, Python, ITIL practices, cloud imaging solutions, and enterprise image exchange.
• Preferred experience with Medicalis or another workflow orchestration / worklist and clinical decision support platform.
• Experience with cloud-hosted or hybrid imaging architectures and enterprise image exchange.
• Experience deploying or monitoring imaging AI in production. Imaging AI experience is a plus, not a requirement, for this role.

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