Solution Architect

"Role Summary

Seeking a senior healthcare Solution Architect to lead architecture and solution design for state-specific Medicaid regulatory changes across the health-plan technology ecosystem.

The architect should have deep knowledge of Facets, Mainframe, Java, DataStage, Talend/TalendWorks and healthcare payer architecture, combined with strong Medicaid regulatory and business-process knowledge.

Key Responsibilities

Own end-to-end technical architecture for state-specific Medicaid regulatory changes.

Assess regulatory impacts across:

Facets

Mainframe platforms

Java/J2EE applications

DataStage

Talend/TalendWorks

APIs and integration services

Databases

Batch platforms

Upstream and downstream applications

Determine the appropriate implementation approach across Facets configuration, Mainframe development, Java development, ETL/data changes, integration changes, or surrounding applications.

Design solutions supporting:

Member enrollment

Eligibility

Benefits

Claims adjudication

Claims pricing

Claims payment

Regulatory edits

Medicare/Medicaid coordination

Develop architecture patterns that allow common capabilities to be reused while supporting state-specific Medicaid variations.

Perform regulatory impact assessments and identify cross-platform dependencies.

Provide technical leadership to Mainframe, Java, Facets, ETL, and QA teams.

Conduct architecture reviews, technical quality assessments, and production-readiness reviews.

Identify design gaps, integration risks, data impacts, and downstream regulatory impacts.

Partner with Medicaid regulatory SMEs, business analysts, product owners, engineering, and QA teams.

Required Experience

Deep TriZetto Facets architecture and implementation experience.

Strong Mainframe architecture and application knowledge, including COBOL/JCL/DB2/CICS or comparable technologies.

Strong Java/J2EE architecture and engineering knowledge.

Experience with IBM DataStage.

Experience with Talend/TalendWorks.

Experience with enterprise APIs, integrations, batch systems, databases, and data architecture.

Strong knowledge of Medicaid managed care and state-specific regulations.

Good understanding of Medicare and Medicaid plan operations.

Deep understanding of membership/eligibility and end-to-end claims processing.

Experience architecting regulatory-driven changes across multiple integrated applications."