Solutions Architect
Job Summary
To transform pharmacy complexity into client success, the full-time Solutions Architect will design end-to-end TPA solutions, manage PBM partnerships, and develop operational workflows while working remotely.
Key responsibilities
- Architect operational workflows across eligibility, claims, billing, and benefit administration to ensure compliance and scalability
- Translate cross-functional operational requirements into structured solutions for various internal teams
- Manage performance reviews and onboarding processes for PBM partners, ensuring all legal and technical requirements are met
Required qualifications
- 7+ years of experience in healthcare, TPA operations, product, or systems architecture
- Background in PBM operations, data file formats, and compliance requirements
- Experience with pharmaceutical rebate structures and drug cost containment strategies
- Knowledge of legal and regulatory requirements governing PBM operations (e.g., HIPAA, CMS)
- Proven ability to map complex processes and design end-to-end workflows
Complete Job Description
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