Facets Solution Architect Lead

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