Principal Solution Architect – Pharmacy/PBM

Lumen Solutions Group Inc • Baltimore, MD

2d • Remote

About The Position

We are seeking a Principal Solution Architect with deep expertise in Pharmacy/PBM architecture, healthcare payer environments, and integration/interoperability. The ideal candidate will have extensive experience with Pharmacy Benefits Administration and PBM operations and will be responsible for architecting the integration of a PBM provider with existing healthcare payer and core systems. This role requires a senior technical leader who can define solution architecture, lead other architects, and collaborate closely with Cybersecurity, Enterprise Data, and other domain architecture teams.

Requirements

• 10+ years of Solution Architecture experience in relevant healthcare/PBM specialization.
• Approximately 10 years of cumulative PBM/Pharmacy Benefits Administration experience; experience does not need to be consecutive.
• Strong Healthcare Payer/PBM industry experience.
• Deep understanding of: PBM models and Pharmacy operations, End-to-end Pharmacy Benefit lifecycle, Formulary and drug list management, Prior authorization, Quantity limits, Accumulator management
• Strong integration and interoperability architecture experience.
• Hands-on architectural knowledge of: HL7 FHIR, X12 / HIPAA EDI, APIs, Event-driven integrations, Real-time integrations, Batch/file-based integrations
• 834 and 837 EDI transactions are mandatory.
• Strong leadership, communication, collaboration, and stakeholder-management skills.
• Demonstrated ability to lead and mentor other architects and drive enterprise-level architecture decisions.

Nice To Haves

• Facets G6 experience is highly desired.
• Experience integrating with Facets.
• Experience with Edifecs.
• Experience working with healthcare payer core systems and PBM providers.

Responsibilities

• Lead solution architecture for Pharmacy/PBM platforms and integrations within a healthcare payer environment.
• Design end-to-end solutions supporting the Pharmacy Benefit lifecycle and PBM operations.
• Define integration strategies between PBM platforms and healthcare payer/core systems.
• Architect real-time, batch, file-based, API, and event-driven integrations.
• Provide technical leadership to architects and cross-functional engineering teams.
• Collaborate with Cybersecurity, Enterprise Data, Enterprise Architecture, and other domain teams.
• Ensure solutions align with healthcare interoperability, security, scalability, and enterprise architecture standards.
• Translate business and pharmacy requirements into scalable technical architecture.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed