Solution Architect
- Sonitalent Corp
51 Days Ago
NA
NA
Remote
8-12 Years
Required Skills: solution architect, Pharmacy Benefits Manager with CMS Interoperability, Healthcare Payer experience, EHRs, HIEs, HL7, FHIR, API Integration
Job Description
Job Title: Solution Architect/Pharmacy Benefits Manager (PBM) with CMS Interoperability Expertise
Location: Candidates on the West Coast (PST Hours) 100% REMOTE
Duration: 6+ months
Interview: Phone/ Skype-2Rounds
Linkedin Must have
Job Description:
We are looking for a Solution Architect/Pharmacy Benefits Manager (PBM) with CMS Interoperability that has healthcare payer experience.
We are seeking a highly skilled and experienced Solution Architect/Pharmacy Benefits Manager (PBM) with a strong background in CMS Interoperability and healthcare payer operations. The ideal candidate will have a proven ability to design and implement innovative solutions that align with regulatory requirements, optimize business processes, and enhance the interoperability of healthcare data systems.
Key Responsibilities:
- Solution Architecture: Design and implement scalable, secure, and compliant solutions to address CMS Interoperability requirements, ensuring alignment with organizational goals and industry standards.
- CMS Interoperability Expertise: Lead the development and implementation of strategies to enhance healthcare data exchange and interoperability, including working with HL7 FHIR standards, API development, and data mapping.
- Healthcare Payer Insights: Leverage in-depth knowledge of healthcare payer systems to analyze, design, and optimize processes for managing pharmacy benefits.
- Regulatory Compliance: Ensure that all solutions adhere to CMS guidelines, HIPAA regulations, and other relevant compliance frameworks.
- Collaboration: Work closely with cross-functional teams, including business analysts, developers, and stakeholders, to gather requirements, provide technical guidance, and deliver effective solutions.
- Technical Leadership: Stay up to date with the latest advancements in healthcare interoperability and pharmacy benefit management, and provide strategic input to drive innovation and efficiency.
- Testing & Implementation: Oversee testing, deployment, and post-implementation support of interoperability solutions and PBM systems.
Qualifications:
- Bachelor's degree in computer science, healthcare administration, or a related field (master’s preferred).
- Proven experience as a Solution Architect and PBM professional in the healthcare payer space.
- Experience with CMS Interoperability guidelines, including FHIR standards and API integration.
- Expertise in healthcare payer processes, including claims processing, formulary management, and benefit design.
- Familiarity with healthcare IT systems such as EHRs, HIEs, and payer platforms.
- Strong communication and collaboration skills, with the ability to work effectively in a team environment.
- Certifications in healthcare IT standards (e.g., HL7, FHIR) are a plus.
