NCPDP jobs in Pennsylvania

Remote

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5d ago

100% remote role but need to come onsite once in every 3 months. (expenses will be paid for the travel) What the role will involve: The resource will be working with other domain architects and the PBM provided. Will be working on the architecture on how the PBM provider integrated back in the CareFirst systems. Must haves: Looking for resources will solid solution architecture in the PBM space. Must have 10+ years Solution Architecture experience with around 10 years of PBM experience. Solid PB

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Contract

Depends on Experience

ITX Developer (IBM Transformation Extender) Healthcare EDI

Remote

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24d ago

ITX Developer (IBM Transformation Extender) Healthcare EDILocation: Remote (USA) Job Type: Contract / Long-Term Job SummaryWe are seeking an experienced IBM ITX (IBM Transformation Extender) Developer with strong expertise in Healthcare EDI and NCPDP transactions to join our integration team. The ideal candidate will have hands-on experience developing and maintaining ITX maps, implementing HIPAA-compliant EDI solutions, and working with healthcare transaction standards. This role requires both

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Full-time

Depends on Experience

Clinical Informatics Data Architect

Remote or Dallas, Texas

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Today

Who We Are Verily Health is a data platform and technology company purpose-built to power AI-enabled precision health solutions that accelerate research and improve care for individuals and communities. Uniquely positioned at the intersection of technology, data science, and healthcare, Verily transforms multimodal health data into insights, models, and actions that make healthcare more personalized, predictive, and precise. Description Verily Health is seeking a highly motivated and detail-o

Full-time

USD 102,000.00 - 154,000.00 per year

Informatica B2B Developer (C07) EDI X12 5010 Healthcare

Remote

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11d ago

Summary SQN Systems is seeking an experienced Informatica B2B Developer with deep expertise in Informatica B2B Data Transformation. This role designs, builds, and supports secure, scalable B2B Informatica-based EDI solutions across various single and multi-tenant healthcare platforms. Requires strong understanding and experience with multiple healthcare standard transaction types, with an emphasis on ANSI X12 5010 transaction sets. Required applications without these will not be considered Hand

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Full-time

Pharmacy Interface Certification Engineer

Remote or Irving, Texas

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Today

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patien

Full-time

USD 106,100.00 - 176,800.00 per year

Analyst III, Network Configuration

Remote

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Today

Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and eac

Full-time

USD 54,236.00 - 64,567.00 per year

Technical Business Analyst

Remote

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16d ago

Job Summary: We are seeking an experienced Business Analyst to support ahigh-priority initiative to upgrade pharmacy claims processing systems from NCPDP Version D.0 to F6. The Business Analyst will partner with business stakeholders, pharmacy operations, compliance teams, and IT development teams to analyze current-state processes, document business and functional requirements, support testing activities, and ensure successful implementation of the new NCPDP F6 standard on the IBM i (AS/400) pl

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Contract

$0 - $0

Lead Software Engineer - Remote

Remote or Schaumburg, Illinois

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Today

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op

Full-time

USD 112,700.00 - 193,200.00 per year

Healthcare Payer PBM Business Architect

Remote

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2d ago

Hiring! Healthcare Payer and PBM Operations Architect - for a contract to hire job opportunity with our direct client. Though this is a 100% remote based job opportunity, we are seeking candidates that are located in the DMV, WVA, PA, NY, NJ or Texas areas. Candidates must be eligible for full time employment and work on a W2 basis. Job requirement: Proficiency in innovating ideas and solutions resulting in tangible and measurable business outcomes.Mastery in creating architecture solutions w

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Contract

Depends on Experience

Sr Data Engineer

Remote or Philadelphia, Pennsylvania

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Today

Company Description IntegriChain is the data and application backbone for market access departments of Life Sciences manufacturers. We deliver the data, the applications, and the business process infrastructure for patient access and therapy commercialization. More than 250 manufacturers rely on our ICyte Platform to orchestrate their commercial and government payer contracting, patient services, and distribution channels. ICyte is the first and only platform that unites the financial, operatio

Full-time

iSeries RPG-RPGLE Developer

Remote

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9d ago

Position: iSeries RPG/RPGLE Developer Contract Duration: Long Term Location: Remote in USA (EST or CST) Need iSeries RPG/RPGLE Developer to support a high-priority initiative to upgrade pharmacy claims processing systems from NCPDP Version D.0 to F6. Position Summary: We are seeking an experienced iSeries RPG/RPGLE Developer to support ahigh-priority initiative to upgrade pharmacy claims processing systems from NCPDP Version D.0 to F6. This role will be responsible for analyzing existing applic

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Contract

Depends on Experience

iSeries developer

Remote

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17d ago

Analyze existing NCPDP D.0 transaction processing workflows and identify modifications required for F6 compliance.Design, develop, test, and implement enhancements to IBM i (AS/400) applications using RPG, RPGLE, SQLRPGLE, CL, and DB2.Modify claim adjudication, billing, eligibility, and pharmacy transaction processing programs to support NCPDP F6 requirements.Update database structures, file specifications, and interfaces supporting pharmacy claims.Develop and maintain inbound and outbound EDI t

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Contract

$40 - $50

Contract role: Clinical Pharma Business Systems Analyst at Florham Park, NJ (Remote) || W2 Only

Remote or New Jersey

•

Today

Clinical Pharma Business Systems Analyst Florham Park, NJ (Remote) Long Term Contract Job Details: PBM Domain Expertise & Claims Processing FDB Drug Nomenclature, Formulary & Preferred Drug List Design Drug Coverage Configuration: Inclusions, Exclusions & Prior Authorization Criteria NCPDP D.0 Standards & ProDUR Business Rules Business Requirements Elicitation, Analysis & Translation Stakeholder Collaboration with Business, Clinical, Development & Testing Teams Process Workflows, Use Cases, Wi

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Contract

PBM and Pharmacy Claims QA Tester (7+ years of Experience required)

Remote

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2d ago

Job Description: Job Title: QA Tester (Pharmacy claims and PBM testing experience) Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: We re looking for a Test Engineer with strong pharmacy claims and PBM testing experience to support an NCPDP D.0 to F6 implementation. This role is responsible for validating transaction changes, claim adjudication outcomes, eligibility and coordination of benefits scenarios, reject messaging, payer sheet impacts, data mapping, r

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Full-time

$70,000 - $85,000

Pharmacy Claims & PBM Domain Tester - Remote

Remote

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2d ago

Job Details: Pharmacy Claims & PBM Domain Testing NCPDP D.0 / F6 Standards & Migration Validation Claim Adjudication, Eligibility, COB, Pricing & Reject Messaging Test Planning, Test Cases, Test Scripts, Traceability & Test Data Functional, SIT, UAT, Regression, Integration, E2E, Parallel, Release & Production Validation SQL, Backend Data Validation, Reconciliation & Claims Data Analysis Payer Sheet, Field Mapping, Business Rules & Transaction Specification Analysis Defect Manage

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Third Party, Contract

Depends on Experience

Contract role: Sr QA Test Engineer (Pharma Claims) at Florham Park, NJ (Remote)

Remote or New Jersey

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Today

Sr QA Test Engineer Florham Park, NJ (Remote) Long Term Contract Job Details: Pharmacy Claims & PBM Domain Testing NCPDP D.0 / F6 Standards & Migration Validation Claim Adjudication, Eligibility, COB, Pricing & Reject Messaging Test Planning, Test Cases, Test Scripts, Traceability & Test Data Functional, SIT, UAT, Regression, Integration, E2E, Parallel, Release & Production Validation SQL, Backend Data Validation, Reconciliation & Claims Data Analysis Payer Sheet, Field Mapping, Business Rules

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Contract

QA Test Engineer - Pharma, Remote - 69790

Remote

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Today

QA Test Engineer - Pharma, Remote We have an immediate need for an experienced Senior QA Test Engineer with strong expertise in Pharmacy Claims, PBM systems, healthcare transaction processing, and end-to-end testing to design, execute, and support comprehensive testing initiatives for complex claims adjudication platforms. This is a remote position based in Florham Park, NJ, for a candidate with deep experience in Pharmacy Claims & PBM Domain Testing, NCPDP D.0/F6 Standards, Claims Adjudic

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Contract

$40.00 - 42.00

Business Analyst with Pharmacy Benefits Management

Remote

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9d ago

Position: Business Analyst with Pharmacy Benefits Management 100% Remote Hiring: W2 Contract / Fulltime Job Description: We are looking to onboard a Senior Business Analyst in Manager role or Individual contributor depending on experience level. This person will have deep PBM domain expertise and who will help guide the roadmap and feature enhancements for the PBM product suite. This person will serve as a bridge between the Business users and/or Clinical end users (Pharmacists) and the techni

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Full-time

Depends on Experience

Principal Solution Architect - Pharmacy/PBM

Remote

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5d ago

Must-Have: Must have a Laptop/computer with internet to work from home. Comfortable providing a Photo ID Copy Terms of Employment: Duration: W2 Contract-to-Hire, 6-Months Location: 100% Remote (Must reside within MD, DC, VA, WV, PA, DE, NJ, NY, NC, FL & TX) Travel required maximum of once per quarterOverview: Client is seeking a Senior Principal Solution Architect to partner with a leading healthcare organization. In this role, you will lead high-profile solution architecture initiatives wit

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Contract

$70+

Business Analyst With Pharmacy Benefit Management - Remote

Remote

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3d ago

We are looking to onboard a Senior Business Analyst in Manager role or Individual contributor depending on experience level. This person will have deep PBM domain expertise and who will help guide the roadmap and feature enhancements for the Client PBM product suite. This person will serve as a bridge between the Business users and/or Clinical end users (Pharmacists) and the Technical team (Developers and Testers primarily). Minimum Qualifications: EXPERIENCE LEVEL: Ideally 10+ years experience

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Contract, Third Party

$55

NCPDP jobs in Pennsylvania, USA