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Location: Remote EST

Duration: Multi year contract

Position Responsibilities:

Lead the evaluation and selection of technical tools, platforms, and vendors across core payer domains: claims processing, provider network management, care management, member engagement, and analytics.Develop comprehensive technology roadmaps that balance innovation, scalability, cost efficiency, and compliance with payer-specific regulations (HIPAA, CMS, NCQA).Architect end-to-end solutions that integrate core administration systems (e.g., Facets, QNXT, HealthEdge) with data warehouses, analytics platforms, and digital engagement tools.Design interoperability frameworks leveraging industry standards (FHIR, HL7, EDI X12) to enable seamless data exchange across payers, providers, and regulatory agencies.Assess existing technology environments, identify modernization opportunities, and recommend cloud migration, API-first, and microservices-based approaches where applicable.Assess the overarching problems and solutions by listening to the BRD sessions, reading the Business Requirements Documents, and connecting with the BA afterward.Be very tactful with soft skills to be respectful working as a team. This is the key piece of this role.Partner with executives and business leaders to translate business strategy into scalable, secure, and compliant architectures.Ensure architecture governance, technical best practices, and performance benchmarks are met across projects.Provide thought leadership on emerging technologies such as AI-driven claims adjudication, predictive analytics for population health, and automation in provider and member workflows.

Required Skills:

8+ years in healthcare payer technology roles, including architect-level design and strategic consulting experience.Hands-on experience with core administration platforms (e.g., Facets, QNXT, HealthEdge), enterprise integration tools, and cloud technologies (AWS, Azure, GCP).Cutting Edge technical knowledge: up to date on current applications, vendors, etc.Diverse experience across applications of all types - Cloud, Data, Infrastructure, Network - all within health insurance/payersProven success in tool/vendor selection, roadmap creation, and solution architecture for payer organizations.Excellent soft skills translating respect - communicate with clients well, speak to the business usersDeep knowledge of payer operations, regulatory requirements, and healthcare data standards.Hands-on experience with core administration platforms (e.g., Facets, QNXT, HealthEdge), enterprise integration tools, and cloud technologies (AWS, Azure, GCP).Strong understanding of enterprise architecture frameworks (TOGAF, Zachman) and modern architectural patterns (microservices, event-driven, API-first).Excellent leadership, communication, and stakeholder engagement skills. T1427253-PHI_1756302986 To Apply for this Job Click Here