Solution Architect/Engineer – Healthcare Payer Systems

MBI Digital Corp; United States; Remote; USD 125,000 - 250,000; Full time

Job summary

A leading company in healthcare technology is seeking an experienced Solution Architect/Engineer to lead the implementation of their Payment Integrity solution. This remote position requires expertise in payer operations and healthcare data integration, focusing on delivering scalable solutions for healthcare payer systems. The ideal candidate will have a strong background in claims processing and technical leadership, ensuring compliance with industry standards while driving innovative solutions. Join a team dedicated to enhancing healthcare payment systems and making a significant impact in the industry.

Qualifications

• 5+ years of experience in a healthcare payer environment.
• Experience with Zelis Payment Integrity and TPA implementation preferred.

Responsibilities

• Lead solution architecture for Zelis Payment Integrity and TPA projects.
• Collaborate with stakeholders to define technical strategies.
• Ensure compliance with HIPAA and healthcare data security standards.

Skills

Claims Adjudication

Healthcare Data Management

Problem-Solving

Communication

Leadership

Agile

DevOps

Tools

SQL

ETL

Data Warehouse

Zelis Payment Integrity

Trizetto Facets

Job description

Solution Architect/Engineer – Healthcare Payer Systems

Solution Architect/Engineer – Healthcare Payer Systems

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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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

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