01Overview
Description :
Role : Solution Architect - Claims Platform (Life & Health)
Purpose :
Own the end-to-end solution architecture for the Claims Platform for large, global insurers across Life and Health insurance lines.
This role is responsible for ensuring the platform is implemented correctly, integrated effectively within complex insurer ecosystems, and successfully taken from discovery through production go-live.
The Solution Architect acts as the single point of architectural ownership across customer stakeholders, internal product teams, delivery teams, implementation partners, and third-party vendors.
This is not a purely advisory or remote architecture role.
The expectation is that the individual has operated on the ground, worked closely with insurers during critical implementation phases, handled ambiguity, and made real-time decisions during UAT, cutover, and go-live.
Core Responsibilities :
1.International On-Site Implementation Ownership (Mandatory) :
- Must have prior experience travelling internationally for enterprise insurance platform implementations.
- Must have led implementations on-site from requirements gathering through solution design, UAT, cutover, go-live, and hypercare.
- Serve as the primary architectural authority during customer engagements and represent the product confidently in front of senior stakeholders.
Work closely with :
- Claims business teams
- Operations teams
- Customer IT, architecture, and security teams
- System integrators
- Third-party vendors and external partners Drive workshops to understand processes, future-state
- Convert business requirements into practical, scalable solution designs while balancing product capability versus customer-specific customisation.
- Handle ambiguity during discovery phases and bring structure to incomplete or evolving requirements.
- Make real-time decisions during testing, cutover, and production support situations.
- Support high-pressure go-live activities, defect triage, business escalations, and hypercare.
- Ensure customer confidence through strong communication, ownership, and decisive problem-solving.
Enterprise Integration Ownership :
- Own end-to-end integration architecture between the Claims Platform and the insurer ecosystem.
Hands-on experience integrating claims solutions with :
- Policy Administration Systems
- CRM and omni-channel platforms
- Document Management Systems (DMS)
- Payment and finance systems
- External provider, hospital, TPA, and regulatory ecosystems
- Customer communication platforms such as SMS, email, portals, and contact centres
- Define and drive the overall API and integration strategy for customer implementations.
- Design synchronous and asynchronous integration patterns across upstream and downstream systems.
- Own error handling, retry mechanisms, exception management, reconciliation, and operational monitoring for integrations.
- Ensure end-to-end data consistency and transaction integrity across multiple systems.
- Work with customer enterprise architects and integration teams to ensure the solution fits within the broader insurer landscape.
- Support data mapping, interface specifications, payload definitions, and integration testing.
- Provide architectural guidance on performance, dependency management, and system interoperability.
Claims Product & Domain Mastery :
- Demonstrate deep expertise in Life and Health claims processes and operating models.
Strong understanding of :
- Pre-authorisation workflows
- Reimbursement and cashless claims
- Auto-adjudication and manual assessment flows Claims intake and registration
- Medical coding and clinical pathways
- Provider and hospital workflows
- Claims payment, settlement, and recovery
- Fraud, Waste, and Abuse controls
- Claims correspondence and communication processes
- Guide customers on how to use the platform effectively rather than over- customising it.
- Identify where customer requirements can be solved through product configuration versus custom development.
- Ensure solution designs align with industry best practices and support operational efficiency.
- Understand the broader impact of claims processes on customer experience, operational teams, provider networks, and downstream finance systems.
- Be able to challenge customer requests when they introduce unnecessary complexity, operational risk, or deviation from the product roadmap.
- Act as a trusted advisor to business stakeholders by combining deep claims knowledge with practical implementation experience.
Experience Profile :
- 10-12 years of total experience
- 2- 4+ years of experience specifically in Life and Health Claims platforms Proven experience leading international, on-site insurance implementations
- Strong exposure to APAC, EMEA, or other global insurer environments
- Experience working across complex insurer IT landscapes and multiple stakeholder groups
- Hands-on involvement in large-scale .
