Solution Architect/Engineer – Healthcare Payer Systems

MBI Digital Corp; United States; Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking an experienced Solution Architect/Engineer to lead the implementation of innovative healthcare payer solutions. This remote role focuses on the Zelis Payment Integrity solution and Third-Party Administrator projects, requiring deep expertise in payer operations and claims processing. The ideal candidate will drive technical strategies, design integration solutions, and ensure compliance with healthcare data security standards. Join a dynamic team to make a significant impact in the healthcare sector, working collaboratively to enhance data exchange and operational efficiency. This is a fantastic opportunity for a skilled professional to contribute to critical projects in a supportive environment.

Qualifications

• 5+ years as a Solution Architect in healthcare payer systems.
• Strong understanding of claims adjudication and provider payments.

Responsibilities

• Lead architecture and implementation for healthcare payment solutions.
• Collaborate with stakeholders to define technical strategies.

Skills

Solution Architecture

Healthcare Payer Operations

Claims Processing

Provider Payments

Data Integration

Problem-Solving

Communication Skills

Leadership Skills

Agile Methodologies

DevOps Methodologies

Tools

Zelis Payment Integrity

Trizetto Facets

SQL

ETL Processes

Cloud Platforms

Data Warehouse Solutions

Job description

Solution Architect/Engineer – Healthcare Payer Systems

MBI Digital is looking for an experienced Solution Architect/Engineer with 5+ years of experience as a Solution Architect or Engineer in a healthcare payer environment to take a lead role in the 2025 project portfolio. This position will drive the implementation of the Zelis Payment Integrity solution and a Third-Party Administrator (TPA).

The ideal candidate will have deep expertise in payer operations, claims processing, provider payments, and healthcare data integration and lead solution architecture, design, and implementation for Zelis Payment Integrity and TPA platform projects.

This is a 100% remote opportunity with 8-9 months project engagement with possibility of extension.The candidate should be willing to work in the Pacific time zone.

Job Responsibilities:

• Lead solution architecture, design, and implementation for Zelis Payment Integrity and TPA platform projects.
• Collaborate with business and IT stakeholders to define technical strategies that align with organizational goals.
• Design integration solutions to enable efficient data exchange between payer platforms, claims processing systems, and external vendors.
• Provide technical leadership for system migrations, enhancements, and data transformations.
• Develop high-level and detailed solution designs, including system architecture diagrams, workflows, and API integrations.
• Ensure compliance with HIPAA, HITRUST, and other healthcare data security standards.
• Engage with vendors and third-party solution providers to evaluate and implement scalable solutions.
• Troubleshoot complex system issues and drive resolution across multi-functional teams.

Qualifications & Skills:

• 5+ years of experience as a Solution Architect or Engineer in a healthcare payer environment.
• Strong understanding of claims adjudication, provider payments, and healthcare data management.
• Experience with the Zelis Payment Integrity solution and TPA implementation is highly preferred.
• Experience with payer platforms such as Trizetto Facets.
• Proficiency in cloud platforms and data pipelines.
• Strong background in SQL, ETL processes, and data warehouse solutions.
• Familiarity with networking, security, IAM, data governance, and compliance frameworks related to healthcare IT.
• Excellent problem-solving, communication, and leadership skills.
• Experience with Agile and DevOps methodologies.