Cloud & IT Staffing Solutions in Chicago, Boston, Dallas
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Job Details

Payer Solutions Architect

Current job openings at Peterson Technology Partners
Current job openings at Peterson Technology Partners
Details
  • Req No : 105824
  • Number of Position : 1
  • Priority : High
Location

Chicago, USA

Employment Type
  • Work Authorization Status : greencard, h1b, h4ead, l2ead, opt, uscitizen
  • Duration : 6 months+
  • Location : Remote
Technical Profile
  • Position Title : Payer Solutions Architect
  • Professional Experience : 8
  • Primary Skills : Solutions Architecture, Payer Operations, Data Architecture, CRM, Integration & API, Facets, QNXT
  • Additional Notes : contract

Contact

Anant N Awatare

Anant N Awatare

anant@ptechpartners.com Peterson Technology Partners on LinkedIn

Job Description:

Our client is seeking a Payer Solution Architect to design and deliver scalable, business-aligned technology solutions for health plan clients. This role bridges business architecture, systems, data, and delivery, translating complex payer requirements into practical solution designs.

The ideal candidate brings deep expertise in the U.S. healthcare payer ecosystem (Medicaid, Medicare Advantage, Commercial, ACA) and understands how platforms, data, integrations, and operations work together.

Key Responsibilities:

Solution Architecture & Strategy:

  • Design end-to-end solutions across payer operations (claims, enrollment, billing, provider, care management, digital, analytics)
  • Translate business needs into scalable architecture and implementation roadmaps
  • Define current/future state architectures and evaluate solution options, risks, and tradeoffs

Payer Platform & Domain Expertise:

  • Provide expertise across core admin platforms (Facets, QNXT, HealthRules, ika)
  • Work with CRM (Salesforce), care management (GuidingCare, Jiva), and data platforms
  • Design solutions accounting for payer complexities (claims, eligibility, benefits, risk adjustment, regulatory reporting)

Integration & Data Architecture:

  • Define integrations using APIs, EDI, HL7/FHIR, batch, and event-driven patterns
  • Support data flow design, data models, and data quality controls across key domains (member, provider, claims, clinical, financial)

Delivery Leadership:

  • Guide cross-functional teams (BA, Dev, Data, QA, vendors) through design and delivery
  • Identify risks, dependencies, and ensure alignment across workstreams
  • Support planning, estimation, governance, and implementation execution

Client Advisory:

  • Act as a trusted advisor to business and technology stakeholders
  • Lead workshops and communicate complex concepts in business terms
  • Support pre-sales, solutioning, and client engagements

Required Qualifications:

  • 8+ years in payer technology, solution architecture, or consulting
  • Strong knowledge of health plan operations (claims, enrollment, billing, care management, etc.)
  • Experience with payer platforms, integrations, data architecture, or digital transformation
  • Familiarity with EDI transactions, interoperability standards, and payer data domains
  • Proven ability to translate business requirements into architecture designs and roadmaps
  • Strong stakeholder management and communication skills

Preferred Qualifications:

  • Experience with Facets, QNXT, HealthRules, or similar platforms
  • Exposure to Salesforce Health Cloud / Service Cloud
  • Knowledge of CMS, Medicare/Medicaid, ACA, risk adjustment, HEDIS, Stars
  • Experience with cloud platforms (AWS, Azure, GCP; Snowflake, Databricks)
  • Familiarity with integration tools (MuleSoft, Boomi, Informatica) and standards (FHIR, HL7, X12)
  • Consulting experience with healthcare payer clients

Rate: $75-$95/hour (depends on experience level). This is a contract position with candidates expected to work 40 hours/ week. 

About Us

Peterson Technology Partners (PTP) is an Equal Opportunity Employer committed to creating a transparent, inclusive, and human-centered hiring experience.

For more than 28 years, PTP has operated as one of the top IT staffing and recruiting firms in the USA—built on trust, long-term partnerships, and technical excellence.

Based in the Chicago suburb of Park Ridge, IL, our team of more than 500 employees and consultants is dedicated to:

  • Helping every client make the best hiring decisions possible
  • Matching professionals with the right IT jobs and career opportunities

As part of that commitment, we believe in providing clear information about how our hiring technologies work and how your data is used. The following section outlines our AI-assisted interview process and your rights as a candidate.

AI-Assisted Interview Experience (Pete & Gabi – Rebecca):

To provide a consistent, fair, and flexible experience for all candidates, we use AI-assisted tools to support parts of the interview process. This includes our proprietary AI platform Pete & Gabi, which includes AI recruiter Rebecca.

These AI hiring tools help us:

  • Transcribe interviews
  • Summarize candidate responses
  • Generate job-related insights
  • Streamline communication and scheduling

Please note that:

  • The AI does NOT make hiring decisions; all decisions are made by our human recruiters, hiring managers, or client partners.
  • The AI does not evaluate facial expressions, emotions, or physical traits; it is used only to support fairness, consistency, and efficiency.

If you prefer a non-AI interview format, we will gladly provide an alternative.

Technical or Case Interviews (Role-Dependent):

When applying for certain tech jobs, you may participate in:

  • A technical interview
  • A coding challenge
  • A case study
  • A client-specific assessment

We will always explain what to expect in advance so you can prepare with confidence.

Human Review & Selection: +

Every candidate’s profile—including interviews, conversations, and assessments—is reviewed by experienced recruiters and hiring leaders.

AI insights may assist with organization and evaluation, but final decisions are always human-driven.

Your Rights as a Candidate: +

At PTP, every candidate has the right to:

  • Request a non-AI interview path
  • Ask how your data is being used
  • Request access to transcripts or interview recordings
  • Request deletion of your AI-recorded interview
  • Receive clear, timely communication

Our goal is to ensure you feel respected, informed, and supported throughout your experience.

Our Commitment: +

For more than 28 years, PTP has focused on putting people first—candidates, consultants, employees, and clients.

We’re committed to a hiring process that is:

  • Transparent
  • Compliant
  • Equitable
  • Powered by innovative technology that enhances—not replaces—human judgment

Welcome to the future of hiring at Peterson Technology Partners.

We’re excited to learn more about you.

Equal Employment Opportunity: +

Peterson Technology Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, national origin, gender identity, sexual orientation, disability, veteran status, or any other protected characteristic.

Payer Solutions Architect

Current job openings at Peterson Technology Partners
Current job openings at Peterson Technology Partners
Details
  • Req No : 105824
  • Number of Position : 1
  • Priority : High
Location

Chicago, USA

Employment Type
  • Work Authorization Status : greencard, h1b, h4ead, l2ead, opt, uscitizen
  • Duration : 6 months+
  • Location : Remote
Technical Profile
  • Position Title : Payer Solutions Architect
  • Professional Experience : 8
  • Primary Skills : Solutions Architecture, Payer Operations, Data Architecture, CRM, Integration & API, Facets, QNXT
  • Additional Notes : contract

Contact

Anant N Awatare

Anant N Awatare

anant@ptechpartners.com Peterson Technology Partners on LinkedIn

Job Description:

Our client is seeking a Payer Solution Architect to design and deliver scalable, business-aligned technology solutions for health plan clients. This role bridges business architecture, systems, data, and delivery, translating complex payer requirements into practical solution designs.

The ideal candidate brings deep expertise in the U.S. healthcare payer ecosystem (Medicaid, Medicare Advantage, Commercial, ACA) and understands how platforms, data, integrations, and operations work together.

Key Responsibilities:

Solution Architecture & Strategy:

  • Design end-to-end solutions across payer operations (claims, enrollment, billing, provider, care management, digital, analytics)
  • Translate business needs into scalable architecture and implementation roadmaps
  • Define current/future state architectures and evaluate solution options, risks, and tradeoffs

Payer Platform & Domain Expertise:

  • Provide expertise across core admin platforms (Facets, QNXT, HealthRules, ika)
  • Work with CRM (Salesforce), care management (GuidingCare, Jiva), and data platforms
  • Design solutions accounting for payer complexities (claims, eligibility, benefits, risk adjustment, regulatory reporting)

Integration & Data Architecture:

  • Define integrations using APIs, EDI, HL7/FHIR, batch, and event-driven patterns
  • Support data flow design, data models, and data quality controls across key domains (member, provider, claims, clinical, financial)

Delivery Leadership:

  • Guide cross-functional teams (BA, Dev, Data, QA, vendors) through design and delivery
  • Identify risks, dependencies, and ensure alignment across workstreams
  • Support planning, estimation, governance, and implementation execution

Client Advisory:

  • Act as a trusted advisor to business and technology stakeholders
  • Lead workshops and communicate complex concepts in business terms
  • Support pre-sales, solutioning, and client engagements

Required Qualifications:

  • 8+ years in payer technology, solution architecture, or consulting
  • Strong knowledge of health plan operations (claims, enrollment, billing, care management, etc.)
  • Experience with payer platforms, integrations, data architecture, or digital transformation
  • Familiarity with EDI transactions, interoperability standards, and payer data domains
  • Proven ability to translate business requirements into architecture designs and roadmaps
  • Strong stakeholder management and communication skills

Preferred Qualifications:

  • Experience with Facets, QNXT, HealthRules, or similar platforms
  • Exposure to Salesforce Health Cloud / Service Cloud
  • Knowledge of CMS, Medicare/Medicaid, ACA, risk adjustment, HEDIS, Stars
  • Experience with cloud platforms (AWS, Azure, GCP; Snowflake, Databricks)
  • Familiarity with integration tools (MuleSoft, Boomi, Informatica) and standards (FHIR, HL7, X12)
  • Consulting experience with healthcare payer clients

Rate: $75-$95/hour (depends on experience level). This is a contract position with candidates expected to work 40 hours/ week. 

About Us

Peterson Technology Partners (PTP) is an Equal Opportunity Employer committed to creating a transparent, inclusive, and human-centered hiring experience.

For more than 28 years, PTP has operated as one of the top IT staffing and recruiting firms in the USA—built on trust, long-term partnerships, and technical excellence.

Based in the Chicago suburb of Park Ridge, IL, our team of more than 500 employees and consultants is dedicated to:

  • Helping every client make the best hiring decisions possible
  • Matching professionals with the right IT jobs and career opportunities

As part of that commitment, we believe in providing clear information about how our hiring technologies work and how your data is used. The following section outlines our AI-assisted interview process and your rights as a candidate.

AI-Assisted Interview Experience (Pete & Gabi – Rebecca):

To provide a consistent, fair, and flexible experience for all candidates, we use AI-assisted tools to support parts of the interview process. This includes our proprietary AI platform Pete & Gabi, which includes AI recruiter Rebecca.

These AI hiring tools help us:

  • Transcribe interviews
  • Summarize candidate responses
  • Generate job-related insights
  • Streamline communication and scheduling

Please note that:

  • The AI does NOT make hiring decisions; all decisions are made by our human recruiters, hiring managers, or client partners.
  • The AI does not evaluate facial expressions, emotions, or physical traits; it is used only to support fairness, consistency, and efficiency.

If you prefer a non-AI interview format, we will gladly provide an alternative.

Technical or Case Interviews (Role-Dependent):

When applying for certain tech jobs, you may participate in:

  • A technical interview
  • A coding challenge
  • A case study
  • A client-specific assessment

We will always explain what to expect in advance so you can prepare with confidence.

Human Review & Selection: +

Every candidate’s profile—including interviews, conversations, and assessments—is reviewed by experienced recruiters and hiring leaders.

AI insights may assist with organization and evaluation, but final decisions are always human-driven.

Your Rights as a Candidate: +

At PTP, every candidate has the right to:

  • Request a non-AI interview path
  • Ask how your data is being used
  • Request access to transcripts or interview recordings
  • Request deletion of your AI-recorded interview
  • Receive clear, timely communication

Our goal is to ensure you feel respected, informed, and supported throughout your experience.

Our Commitment: +

For more than 28 years, PTP has focused on putting people first—candidates, consultants, employees, and clients.

We’re committed to a hiring process that is:

  • Transparent
  • Compliant
  • Equitable
  • Powered by innovative technology that enhances—not replaces—human judgment

Welcome to the future of hiring at Peterson Technology Partners.

We’re excited to learn more about you.

Equal Employment Opportunity: +

Peterson Technology Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, national origin, gender identity, sexual orientation, disability, veteran status, or any other protected characteristic.

IT Staffing Firm - PTP