Lead solution architecture and implementation for healthcare payer clients, with a focus on PBM systems, claims management, benefits configuration, and eligibility workflows.
Design cloud-native generative AI solution platforms on AWS and Azure with an emphasis on performance, scalability, resilience, and cost efficiency.
Serve as a strategic technical advisor in client engagements, translating business requirements into technical solutions.
Architect and drive implementation of GenAI-enabled systems, particularly RAG (Retrieval-Augmented Generation) patterns for knowledge-based services.
Collaborate with product, engineering, UX, and QA teams to embed UX-driven test automation frameworks using Python and JavaScript.
Requirements
5+ years of experience in architecting solutions on AWS and/or Azure
Proven experience in PBM systems, including formulary management, prior authorization, and medication adherence workflows
Strong foundation in microservices, event-driven architecture, and API management.
Hands-on expertise in Python and JavaScript for platform development and scripting
Experience with modern test automation frameworks that are UX-focused (e.g., Cypress, Playwright)
Ability to drive the design of CI/CD pipelines and integration of quality assurance into release workflows.
Strong knowledge of GenAI platforms, including RAG patterns, vector databases, prompt engineering, and LLM lifecycle management.
Understanding of how AI can be applied in clinical decision support, prior authorization automation, and member engagement.
Bachelor’s or Master’s degree in Computer Science, Engineering, or a related field
Understanding of the Healthcare Payer ecosystem including claims adjudication, EDI workflows, member/provider systems, and payer-provider data exchange models.
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