The Facets Solution Architect Lead will design, configure, and optimize healthcare systems to support CMS program requirements and operational workflows. This role provides technical leadership to ensure system architecture aligns with federal regulations and supports efficient payer operations.
This is a remote position.
We are seeking a highly experienced Facets Solution Architect Lead to design, configure, and optimize healthcare systems that support CMS program requirements, benefit structures, and operational workflows. This role will serve as a strategic leader, ensuring system configurations align with federal regulations while supporting scalable and efficient payer operations.
Key Responsibilities:
- Lead the design and configuration of the Facets platform to support CMS programs, including Medicare Advantage (MA) and Medicaid
- Architect and maintain system rules, benefit structures, and workflows to ensure accurate claims adjudication and operational efficiency
- Translate complex business and regulatory requirements into scalable system solutions
- Provide technical leadership and guidance across Facets modules and system architecture
- Oversee and support integrations between Facets and third-party systems and technologies
- Analyze system performance, troubleshoot complex issues, and implement long-term solutions
- Collaborate with cross-functional teams including operations, compliance, IT, and external vendors
- Ensure system configurations meet compliance standards and evolving regulatory requirements
- Maintain documentation for system architecture, configurations, and integrations
Requirements
Required Qualifications:
- Minimum of 10 years of hands-on experience with the Facets platform
- At least 3 years of experience working with CMS work products, including Medicare Advantage (MA) or Medicaid
- Proficiency in at least six Facets modules, including:
- Medical Plan
- Member
- Practitioner
- Experience working with Facets version 25.1 or newer
- In-depth knowledge of Facets data architecture and underlying infrastructure
- Proven experience integrating Facets with third-party technologies and systems
- Strong understanding of healthcare payer operations and claims adjudication processes
- Excellent communication skills, with the ability to interface with both technical and non-technical stakeholders