Business Analyst - PBM - claims adjudicator - KE Staffing - Remote | Dice.com

Remote

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12d ago

Position: - Product owner (Rxclaim/PBM)Location: - RemoteType: - ContractNote - Need only on 1099 or W2. C2C will work but only for Self-incorporated consultant.Job DescriptionWe are seeking a highly experienced RxCLAIM Product Owner to lead the product vision, roadmap, and delivery for enterprise PBM solutions. The ideal candidate will have deep hands-on expertise in RxCLAIM, strong exposure to other PBM platforms, and a proven ability to work with business, clinical, and technology stakeholder

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Contract

Depends on Experience

SQL Analyst-PBM

Remote

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29d ago

Job Title: SQL Analyst (Pharmacy Benefit Management) Location: Atlanta GA (Onsite) Duration: 12+Months Required Skills: Strong hands-on experience with SQL (complex joins, subqueries, aggregations, validations)Proven experience in PBM Eligibility processing and validationSolid understanding of eligibility file formats and data flows in PBM environmentsExperience performing manual data validation and reconciliationStrong analytical and problem-solving skillsAbility to clearly communicate issues

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Contract

Depends on Experience

PBM Data Analyst - Rx Claims : Remote

Remote or Hybrid in Newark, New Jersey

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Today

as it is a contract to Hire Newark, NJ Location: Hybrid - Travel to New Jersey office twice in a month. NOTE: This is a 6 month contract-to-hire role, with the opportunity to work directly with the client after the contract period. Must have experience on Rx claims and health insurance payer or PBM environment Rx Claims & Pharmacy Domain Analyse end-to-end Rx claims adjudication workflows, including eligibility, benefit design, formulary, pricing, accumulators, edits, prior authorization, and re

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Contract

$50 - $55

RxCLAIM QA Lead

Remote

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Today

Role: RxCLAIM QA Lead Location: Remote Job Description We are seeking an experienced RxCLAIM QA Lead to lead quality assurance activities for pharmacy benefits management (PBM) systems, with a strong focus on RxCLAIM. The ideal candidate will combine deep domain expertise in pharmacy claims with hands-on QA leadership, ensuring high-quality delivery across complex healthcare platforms. Key Responsibilities Lead end-to-end QA activities for RxCLAIM-based applications, including test strategy, pla

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Contract, Third Party

Depends on Experience

Business Analyst - PBM - claims adjudicator

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