Solution Architect

We are seeking a skilled Solution Architect to lead the architecture design for claims processing systems in the healthcare sector. This role requires expertise in claims system architecture, technology selection, compliance management, and performance optimization. The ideal candidate will collaborate with stakeholders to design scalable, secure, and efficient solutions that integrate seamlessly with healthcare platforms.

Key Responsibilities

• Develop comprehensive architecture blueprints for claims processing systems, ensuring seamless data flow, integration points, and system interfaces

• Analyze business requirements to identify claims processing challenges and translate them into technical specifications

• Evaluate and recommend technology stacks, including platforms, databases, and integration tools, prioritizing scalability and compliance

• Design integration strategies to connect claims systems with EHRs, provider portals, and payer platforms

• Ensure compliance with healthcare regulations, focusing on data privacy and security

• Monitor and optimize system performance to enhance claims processing speed and efficiency

Required Qualifications

• Minimum 5 years of experience with Java, COBOL, and Mainframe

• Minimum 7 years of experience in a Claims Processing or Healthcare environment

• Minimum 3 years of experience in Public Sector projects

• 3 years of experience with healthcare industry standards such as HL7 and EDI

• Strong knowledge of healthcare claims processing workflows, including billing codes, claim adjudication, and reimbursement methodologies

• 3 years of experience in enterprise-grade architecture design, including scalability, security, and data management

• Strong communication and collaboration skills to work with business analysts, developers, and project managers

Preferred Qualifications

• Bachelor’s degree in a related field