Principal Solution Architect Pharmacy/PBM
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Role details
Tech stack
Job description
We are seeking a Principal Solution Architect with deep expertise in Pharmacy/PBM architecture, healthcare payer environments, and integration/interoperability. The ideal candidate will have extensive experience with Pharmacy Benefits Administration and PBM operations and will be responsible for architecting the integration of a PBM provider with existing healthcare payer and core systems. This role requires a senior technical leader who can define solution architecture, lead other architects, and collaborate closely with Cybersecurity, Enterprise Data, and other domain architecture teams., * Lead solution architecture for Pharmacy/PBM platforms and integrations within a healthcare payer environment.
- Design end-to-end solutions supporting the Pharmacy Benefit lifecycle and PBM operations.
- Define integration strategies between PBM platforms and healthcare payer/core systems.
- Architect real-time, batch, file-based, API, and event-driven integrations.
- Provide technical leadership to architects and cross-functional engineering teams.
- Collaborate with Cybersecurity, Enterprise Data, Enterprise Architecture, and other domain teams.
- Ensure solutions align with healthcare interoperability, security, scalability, and enterprise architecture standards.
- Translate business and pharmacy requirements into scalable technical architecture.
Requirements
- 10+ years of Solution Architecture experience in relevant healthcare/PBM specialization.
- Approximately 10 years of cumulative PBM/Pharmacy Benefits Administration experience; experience does not need to be consecutive.
- Strong Healthcare Payer/PBM industry experience.
- Deep understanding of:
- PBM models and Pharmacy operations
- End-to-end Pharmacy Benefit lifecycle
- Formulary and drug list management
- Prior authorization
- Quantity limits
- Accumulator management
- Strong integration and interoperability architecture experience.
- Hands-on architectural knowledge of:
- HL7 FHIR
- X12 / HIPAA EDI
- APIs
- Event-driven integrations
- Real-time integrations
- Batch/file-based integrations
- 834 and 837 EDI transactions are mandatory.
- Strong leadership, communication, collaboration, and stakeholder-management skills.
- Demonstrated ability to lead and mentor other architects and drive enterprise-level architecture decisions., * Facets G6 experience is highly desired.
- Experience integrating with Facets.
- Experience with Edifecs.
- Experience working with healthcare payer core systems and PBM providers.
About the company
Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, Enterprise Transformation.
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