End-to-End PBM & TPA Solutions Architect

Personify Health, Inc.; Tempe (AZ); On-site; USD 85,000 - 118,000; Full time

Benefits offered by this job

Competitive base salary

Unlimited PTO

Mental health support

Career progression budgets

Mission-driven culture

Job summary

Personify Health, Inc. in Tempe, AZ, seeks a senior architect to design end-to-end TPA solutions and lead PBM data workflows. You will translate complex requirements into scalable production-ready designs across Claims, Eligibility, Implementation, and Finance, ensuring compliance and client value.

You will drive PBM partnerships, shape product offerings, negotiate data standards, and educate teams on the PBM landscape to enable strong client outcomes.

Qualifications

• 7+ years in healthcare, TPA operations, product, systems architecture, implementation, or related fields
• Background in PBM operations, data file formats, data dictionaries, and compliance requirements
• Experience with pharmaceutical rebate structures, formulary management, and drug cost containment strategies
• Working knowledge of legal and regulatory requirements governing PBM operations and data sharing (HIPAA, CMS, etc.)
• Track record mapping complex processes and building end-to-end workflow designs

Responsibilities

• Architect end-to-end TPA solutions across eligibility, claims, billing, and benefit administration.
• Translate complex requirements into structured, executable solutions for multiple teams.
• Own PBM solution design and future-state data flows and file exchanges.
• Negotiate data standards and SLAs to protect data integrity and client outcomes.
• Manage PBM partnerships and vendor onboarding end-to-end with compliance cleared before go-live.
• Shape PBM product offerings in collaboration with PBMs.
• Build internal training materials for Account Management, Implementation, and Tech Ops.
• Track drug cost containment and PMPM performance; flag savings opportunities.

Skills

Healthcare experience

TPA operations

Systems architecture

PBM operations

Rebate knowledge

Tools

PBM data formats

Data exchange standards

Pricing agreements

Job description

Personify Health, Inc. in Tempe, AZ, seeks a senior architect to design end-to-end TPA solutions and lead PBM data workflows. You will translate complex requirements into scalable production-ready designs across Claims, Eligibility, Implementation, and Finance, ensuring compliance and client value.

You will drive PBM partnerships, shape product offerings, negotiate data standards, and educate teams on the PBM landscape to enable strong client outcomes.