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Pharmacy Benefit Management Solution Architect

Date:  Sep 20, 2023

Any city, TX, US, 99999

Req ID:  17748

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.



Gainwell Technologies provides pharmacy management services for 19 State Medicaid Fee for Service (FFS) programs.  We deliver: 

  • Pharmacy Point of Sale (POS) claims module to accurately process claims and encounters, to perform drug utilization review, and to perform automated prior authorization services according to the State Medicaid program requirements.  
  • The CMS-certified solution enables  rapid deployment of program and policy changes as they occur throughout the course of the contract.  It is fully integrated with the State’s internal solutions and other trading partners, using the latest technology and automated processes for routine data exchange.  
  • The solution is in compliance with HIPAA privacy and security guidelines, NIST guidelines, and other State and Federal laws, rules, and guidelines.
  • The POS claims module is utilized by the Gainwell call centers to support prescribers, pharmacies, and members in the administration of the State Medicaid pharmacy benefits, including drug prior authorization.
  • Rebate Administration via a cloud-based solution to invoice, collect, and reconcile manufacturer rebate payments predominantly for the Medicaid Drug Rebate Program (MDRP), but may include other federal and state pharmacy sponsored programs.
  • Preferred Drug List Management via negotiation with drug manufacturers on behalf of our State clients and the development and delivery of formulary and prior authorization recommendations to ensure member access to safe and effective therapies.

Your role in our mission

  • Provide recommendations and roadmaps for proposed solutions.
  • Support the technical resources to mature discipline with focus on service-oriented architecture (SOA), and to deliver a modular, interoperable pharmacy solution in alignment with industry and regulatory standard.  
  • Consistently evaluate and implement open-source tools, leveraging industry leading products to meet key business requirements.  Identify opportunities to achieve savings by moving off legacy systems that have higher support costs.
  • Document and share best practice knowledge for new solutions
  • Develop proof-of-concept projects to validate proposed solutions, as well as the technology ROI.
  • Provide technical leadership throughout the project lifecycle
  • Reviewing and validating solutions designs from other team.  Perform design, debug, and performance analysis on pharmacy solutions
  • Advocate for process improvements and help implement the improvements  including relevant documentation
  • Regularly communicate new features and benefits to partners, customers, and other internal and external stakeholders at the leadership level
  • Working knowledge of Azure Dev Ops to enter and track work tickets for product development. 
  • Knowledge of Agile and Waterfall delivery models.

What we're looking for

  • 7 years’ experience in pharmacy engineering and software design
  • In-depth understanding of technology software and coding languages (MS SQL, MS Project, Sharepoint, .NET, HTML, XML, PERL, Java)
  • In-depth pharmacy domain expertise – including transaction standards (NCPDP), reference database elements and structures (First Data Bank, Medispan), switch vendors and trading partners (CoverMyMeds, Surescripts)
  • Must be well versed in CMS guidance and Federal legislation that govern pharmacy administration and operations in the public sector
  • Prior project management experience leading large scale projects, with routine, direct interaction with the client, trading partners, and internal staff.

What you should expect in this role


The pay range for this position is $108,500.00 - $155,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.


We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.


Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

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