Principal Solution Architect – Pharmacy/PBM

Lumen Solutions Group Inc. is a Florida-based technology consulting services company providing experienced business and IT professionals to support clients from solution design through implementation and support. We specialize in professional IT consulting, IT staffing, business/IT strategy, business process blueprints, enterprise architecture, and enterprise transformation.

About the role

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.

Responsibilities

• 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 (mandatory)
• Strong leadership, communication, collaboration, and stakeholder-management skills.
• Demonstrated ability to lead and mentor other architects and drive enterprise-level architecture decisions.

Preferred Qualifications

• Facets G6 experience is highly desired.
• Experience integrating with Facets.
• Experience with Edifecs.
• Experience working with healthcare payer core systems and PBM providers.

Type: 6 months Contract-to-Hire
Location: Reston, VA (100% Remote)