TPA Solutions and Services Architect (Remote from US)

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a TPA Solutions and Services Architect in United States.

In this role, you will act as the strategic bridge between client needs, product capabilities, and operational execution across the TPA ecosystem. You will design end-to-end solution architectures that streamline complex workflows in claims, billing, eligibility, reporting, and member services, ensuring scalable, compliant, and user-centered solutions. Your work will assess current processes, identify gaps, and define future-state architectures that enable operational teams to deliver exceptional service. Collaboration with cross-functional teams will be critical to ensure seamless solution delivery. This position requires a mix of strategic thinking, operational insight, and technical design expertise, making a direct impact on client success and internal efficiency. The role offers an environment that values innovation, accountability, and continuous improvement.

• Design comprehensive, end-to-end solution architectures for health plan administration across TPA platforms, keeping the end user experience central to all designs
• Map and evaluate current operational processes, tools, and data flows to identify fragmentation, redundancies, and opportunities for improvement
• Develop future-state integrated workflows that unify claims, eligibility, billing, reporting, customer service, and product teams for optimal efficiency
• Enable operational teams by providing the resources, knowledge, and support needed to maintain solutions post-implementation
• Collaborate cross-functionally with Account Management, Product, Implementation, and System Configuration teams to ensure smooth solution delivery
• Identify risks and propose scalable, compliant solutions to operational and system challenges
• Serve as a subject-matter expert, guiding stakeholders on best practices and solution design

• 7+ years of experience in healthcare, TPA operations, product, systems architecture, implementation, or related fields
• Proven ability to map complex processes and design end-to-end workflows
• Strong analytical skills with ability to translate ambiguous business needs into actionable solution designs
• Excellent communication skills, including facilitation and documentation, with experience influencing without formal authority
• Strategic thinking with demonstrated ability to bridge client needs, product capabilities, and operational execution
• Collaborative mindset with experience working closely across functional teams
• Commitment to designing user-centered solutions that streamline operations and enhance the client experience

• Competitive base salary within the range of $100,000 to $120,000 annually, with eligibility for 10% target bonus/variable compensation
• Comprehensive health, dental, vision, and mental health benefits effective from day one
• Flexible work arrangements to support work-life balance
• Unlimited PTO policy for rest and recharge
• Retirement planning support and additional voluntary benefits
• Professional development opportunities, mentorship, and learning budget
• Inclusive, collaborative culture with recognition programs, team events, and a focus on DEIB initiatives

Why Apply Through Jobgether?

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

 Why Apply Through Jobgether? 

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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