TPA Solutions and Services Architect
About The Position
As a Solutions and Services Architect, you'll be the strategic bridge connecting client needs, product capabilities, and operational execution across the entire TPA ecosystem. Your work directly shapes how health plans are administered—from eligibility and claims to billing and reporting—ensuring solutions are compliant, scalable, and designed with the end user experience at the forefront. By mapping current systems, identifying gaps, and designing unified future-state architectures, you'll streamline fragmented workflows and enable operational teams to deliver exceptional service. Your influence spans the entire client journey, making you instrumental in turning complex TPA challenges into seamless, integrated solutions.
Requirements
- 7+ years experience in healthcare, TPA operations, product, systems architecture, implementation, or related fields
- Experience mapping complex processes and building end-to-end workflow designs
- Strong ability to translate ambiguous internal needs into structured, actionable solution designs
- Proven success influencing without authority in matrixed environment
- Excellent communication skills including facilitation and documentation abilities
- Strategic thinking with ability to bridge client needs, product capabilities, and operational execution
- Strong cross-functional collaboration and partnership abilities with Account Management, Product, Implementation, and System Configuration teams
- Analytical and assessment skills for identifying fragmentation, gaps, and optimization opportunities across complex TPA systems
- User experience focus with commitment to keeping end user perspective central to all solution designs
- Ability to unify fragmented workflows and create integrated architectures that streamline operations
Responsibilities
- Design comprehensive solutions: Develop end-to-end solution architecture for health plans administered through TPA platform, keeping end user experience top of mind throughout design process.
- Assess current operations: Map and evaluate current-state systems, tools, data flows, and operational processes across TPA organization to identify fragmentation, gaps, redundancies, and streamlining opportunities.
- Create future-state vision: Design integrated architecture that unifies workflows across claims, eligibility, billing, reporting, customer service, platform, and product teams for optimal efficiency.
- Enable operational teams: Ensure operational teams including member services, billing, and claims have resources and knowledge needed to support solutions after go-live.
- Partner cross-functionally: Collaborate closely with Account Management, Product, Implementation, and System Configuration teams to ensure smooth delivery of promised services and seamless execution.
Benefits
- Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!)
- Mental health support and wellness programs designed by experts who get it
- Flexible work arrangements that fit your life, not the other way around
- Retirement planning support to help you build real wealth for the future
- Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
- Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
- Professional development opportunities and clear career progression paths
- Mentorship from industry leaders who want to see you succeed
- Learning budget to invest in skills that matter to your future
- People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
- One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
- We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
- Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable
- Competitive base salary that rewards your success
- Unlimited PTO policy because rest and recharge time is non-negotiable
- Benefits effective day one—because you shouldn’t have to wait to be taken care of
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
