Healthcare Solution Architect (Facets)

About the role

We are seeking a Healthcare Solution Architect with strong healthcare payer, claims/adjudication, and Facets expertise. The ideal candidate will have recent Solution Architecture experience combined with hands-on technical/engineering experience.

Responsibilities

• Design and support end-to-end Facets-based healthcare solutions.
• Define application, integration, and data-flow architecture.
• Optimize claims editing, batch sequencing, and adjudication workflows.
• Collaborate with business, engineering, and technical teams on architecture decisions.
• Develop architecture documentation, integration designs, and data-flow diagrams.
• Identify opportunities to modernize/refactor existing healthcare platforms.

Requirements

• 8–10 years of healthcare payer experience, with strong knowledge of claims and adjudication processes.
• Strong hands-on Facets G6 experience is highly preferred.
• Deep understanding of Facets architecture, modules, data flows, integrations, and claims processing.
• Candidates with 5+ years of strong Facets Legacy experience may also be considered.
• Recent experience as a Solution Architect; engineering/development + architecture backgrounds are welcome.
• Strong experience with Facets integration frameworks, data-flow architecture, refactoring, and integration patterns.
• Experience designing batch processes and sequencing to optimize claims adjudication performance.
• Experience integrating claims editing tools/vendors and determining the optimal sequence for claims editor calls.
• Ability to evaluate architecture and integration approaches to improve claims processing efficiency and performance.
• Experience with government programs and commercial healthcare is preferred.