Solution Architect – Facets Healthcare Payer - 50941

Title: Solution Architect – Healthcare Payer

Duration: 12 Months+

Location: Baltimore, MD (Remote Job)

 

Carefirst is looking for a Solution Architect with strong Healthcare Payer experience, particularly in Facets G6 and Claims Processing, to lead architecture for large-scale modernization and transformation initiatives.

 

Key Requirements:
8–10+ years of experience as a Solution Architect/Domain Architect in the Healthcare Payer space, with strong Claims experience.
5–6+ years of extensive Facets experience; Facets G6 experience is strongly preferred.
Recent experience architecting Facets G6 real-time and batch claims processing, pre-adjudication validation, EDI transactions, claim editing engines, and third-party integrations.
Strong understanding of integration/interoperability between Facets and enterprise data producers/consumers.
Experience modernizing/refactoring Facets claims architecture, including:
Architecture simplification and modernization
Resiliency and controls for high-risk processes
Reducing integration complexity/hops
Provider data rationalization
Legacy platform retirement/runout planning
Strong understanding of Claims, Enrollment, Billing & Payments, Underwriting, Benefits, Partner Programs, and Business Operations.
Experience with one or more of: Salesforce Health Cloud/Data Cloud, MuleSoft, Kafka, Azure/Fabric, or other healthcare platforms.
Expertise across at least two architecture domains, such as Solution/Enterprise Architecture, Integration, Data, Cloud, Interoperability, Software Architecture, or AI.
Strong experience working with business stakeholders, technical teams, enterprise architects, and third-party solution providers.
Ability to define target-state architecture, make complex technology decisions/trade-offs, and communicate/present architecture to senior stakeholders.