Solutions Architect

🔥 49 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $85k - $118k / year

⏰ Full Time

🟠 Senior

🔴 Lead

💻 Solutions Engineer

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Personify Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2023

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Personify Health is the first personalized health platform company, designed to empower individuals and organizations to achieve better health outcomes through tailored solutions and services. They offer a comprehensive range of solutions including wellbeing navigation, care management, and health plan administration, catering to employers, health systems, health plans, and brokers. Their goal is to simplify healthcare experiences and enhance engagement, ultimately helping businesses optimize their investment in employee health and wellbeing.

📋 Description

• Design end-to-end TPA operational workflows across eligibility, claims, billing, and benefit administration • Translate ambiguous cross-functional operational requirements into structured solutions • Map current-state PBM systems and build future-state data flows and file exchanges • Partner with Pharmacy Strategy to establish file formats, data exchange standards, and SLAs • Lead PBM partner performance reviews and escalation management • Drive new vendor onboarding, including legal, data-sharing, and technical requirements through go-live • Partner with PBMs to influence product development for current and prospective clients • Develop training materials and educate Account Management, Implementation, and Tech Ops • Monitor drug cost containment, PMPM performance, and vendor cost outcomes • Identify savings opportunities • Maintain pricing structures and rebate guarantees • Negotiate rebate and pricing agreements • Provide leadership visibility into TPA and PBM operational health • Represent program performance in client reviews • Build SOPs and documentation supporting continuous improvement

🎯 Requirements

• 7+ years of experience in healthcare, TPA operations, product, systems architecture, implementation, or related fields • Background in PBM operations, data file formats, data dictionaries, and compliance requirements • Experience with pharmaceutical rebate structures, formulary management, and drug cost containment strategies • Working knowledge of legal and regulatory requirements governing PBM operations and data sharing, including HIPAA and CMS • Track record mapping complex processes and building end-to-end workflow designs • Knowledge of data management systems and analytics tooling • Knowledge of PBM data file formats and data exchange standards • Knowledge of rebate and pricing agreement structures • Knowledge of process documentation and SOP development tools

🏖️ Benefits

• Competitive base salary • Comprehensive medical and dental through our own health solutions • Unlimited PTO • Mental health support • Retirement planning • Financial protection • Professional development with clear career progression and learning budgets • Mission-driven culture where diverse perspectives drive real impact • Wellness programs • Other employee perks • Full benefits package starting day one