[Hiring] Solutions and Services Architect @Personify Health

Role Description

Ready to become the architect who turns pharmacy complexity into client wins?

• Architect end-to-end TPA solutions:
  • Design operational workflows across eligibility, claims, billing, and benefit administration that stay compliant, scale with client growth, and hold up against real market demands.
• Translate complexity into execution:
  • Turn ambiguous, cross-functional operational requirements into structured solutions that Claims, Eligibility, Implementation, Account Management, Finance, Compliance, and Tech Ops can actually run with.
• Own PBM solution design:
  • Serve as the go-to architect for pharmacy-related work, mapping current-state systems and building future-state data flows and file exchanges that actually hold up in production.
• Negotiate data standards:
  • Partner with Pharmacy Strategy to lock in file formats, data exchange standards, and SLAs that protect data integrity and client outcomes.
• Manage PBM partnerships:
  • Lead performance reviews and escalation management with PBM partners, and drive new vendor onboarding end-to-end — legal, data-sharing, and technical requirements all cleared before go-live.
• Shape PBM product offerings:
  • Partner directly with PBMs to influence what gets built for current and prospective clients.
• Build internal expertise:
  • Develop training materials and educate Account Management, Implementation, and Tech Ops on the PBM landscape and broader TPA operations, so the whole organization gets sharper.
• Track financial performance:
  • Monitor drug cost containment, PMPM performance, and vendor cost outcomes, and flag savings opportunities clients are leaving on the table.
• Manage pricing and rebates:
  • Maintain accurate pricing structures and rebate guarantees, and negotiate rebate and pricing agreements directly.
• Drive operational visibility:
  • Give leadership clear insight into TPA and PBM operational health, represent program performance in client reviews, and build the SOPs and documentation that keep continuous improvement moving.

Qualifications

• 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 (HIPAA, CMS, etc.)
• Track record mapping complex processes and building end-to-end workflow designs

Requirements

• Data management systems and analytics tooling
• PBM data file formats and data exchange standards
• Rebate and pricing agreement structures
• Process documentation and SOP development tools

Benefits

• Competitive base salary and benefits effective day one
• Comprehensive medical and dental through our own health solutions (yes, we use what we build)
• Unlimited PTO—rest and recharge time is non-negotiable
• Mental health support, retirement planning, and financial protection
• Professional development with clear career progression and learning budgets
• Mission-driven culture where diverse perspectives drive real impact on people's health