Principal Solution Architect Pharmacy/PBM

Lumen Solutions Group, Inc.
  • Baltimore, MD
  • Remote
  • Quick Apply
8 days ago

Job Description

Company Description
Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, Enterprise Transformation. 
 
Position: Principal Solution Architect – Pharmacy/PBM
Type: 6 months
Contract-to-Hire
Location: Reston, VA (100% Remote)
 
Position Overview
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.
 
Key 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.
 
Required Qualifications
  • 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.
 
Preferred Qualifications
  • Facets G6 experience is highly desired.
  • Experience integrating with Facets.
  • Experience with Edifecs.
  • Experience working with healthcare payer core systems and PBM providers.
 
Lumen Solutions Group Inc is an equal opportunity employer. All qualified applicants will be considered for employment without regard to any legally protected status.

Numbers & Facts

LocationBaltimore, MD (
Remote
)

Skills

  • Administrative Skillsunmatched
  • Application Programming Interface (API)unmatched
  • Architectural Servicesunmatched
  • Blueprintsunmatched
  • Business Processesunmatched
  • Business Strategyunmatched
  • Communication Skillsunmatched
  • Compensation and Benefitsunmatched
  • Consultingunmatched
  • Cross-Functionalunmatched
  • Electronic Data Interchange (EDI)unmatched
  • Enterprise Architectureunmatched
  • Formularyunmatched
  • HIPAA (Health Insurance Portability and Accountability Act)unmatched
  • HL7 (Health Level 7)unmatched
  • Healthcareunmatched
  • Healthcare Providersunmatched
  • Information Technology Consultingunmatched
  • Internet Securityunmatched
  • Interoperabilityunmatched
  • Leadershipunmatched
  • Mentoringunmatched
  • Pharmacyunmatched
  • Professional Servicesunmatched
  • Technical Leadershipunmatched
  • Technical Recruitingunmatched
  • Technical Supportunmatched

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