Open role
[Remote] Solution Architect – Facets & Medicaid Regulatory Transformation
Note: The job is a remote job and is open to candidates in USA. Meritore Technologies is seeking a senior healthcare Solution Architect to lead architecture and solution design for state-specific Medicaid regulatory changes across the health-plan technology ecosystem. The role assesses cross-platform impacts and determines implementation approaches spanning Facets, Mainframe, Java, data, integrations, and surrounding applications.
Responsibilities
- Own end-to-end technical architecture for state-specific Medicaid regulatory changes
- Assess regulatory impacts across:
- Facets
- Mainframe platforms
- Java/J2EE applications
- DataStage
- Talend/TalendWorks
- APIs and integration services
- Databases
- Batch platforms
- Upstream and downstream applications
- Determine the appropriate implementation approach across Facets configuration, Mainframe development, Java development, ETL/data changes, integration changes, or surrounding applications
- Design solutions supporting:
- Member enrollment
- Eligibility
- Benefits
- Claims adjudication
- Claims pricing
- Claims payment
- Regulatory edits
- Medicare/Medicaid coordination
- Develop architecture patterns that allow common capabilities to be reused while supporting state-specific Medicaid variations
- Perform regulatory impact assessments and identify cross-platform dependencies
- Provide technical leadership to Mainframe, Java, Facets, ETL, and QA teams
- Conduct architecture reviews, technical quality assessments, and production-readiness reviews
- Identify design gaps, integration risks, data impacts, and downstream regulatory impacts
- Partner with Medicaid regulatory SMEs, business analysts, product owners, engineering, and QA teams
Skills
- Deep TriZetto Facets architecture and implementation experience
- Strong Mainframe architecture and application knowledge, including COBOL/JCL/DB2/CICS or comparable technologies
- Strong Java/J2EE architecture and engineering knowledge
- Experience with IBM DataStage
- Experience with Talend/TalendWorks
- Experience with enterprise APIs, integrations, batch systems, databases, and data architecture
- Strong knowledge of Medicaid managed care and state-specific regulations
- Good understanding of Medicare and Medicaid plan operations
- Deep understanding of membership/eligibility and end-to-end claims processing
- Experience architecting regulatory-driven changes across multiple integrated applications
Benefits
- Remote work
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