Role: RxCLAIM SME Location: Remote Required: Minimum of 8+ years' experience in PBM operations, with direct involvement in plan design and configuration. Deep expertise in RxCLAIM or comparable adjudication systems. Familiarity with NCPDP standards and formulary management. Strong understanding of Commercial & Medicare benefit structures involving Formularies/Drug lists, Pharmacy Networks and Pricing (Client/Pharmacy) Excellent analytical and documentation skills, with ability to translate busin
2+years of pharmacy benefits management (PBM) experience in data analytics. Prior experience with formulary coding options and pharmacy network configuration, claims adjudication experience (preferred).SQL experience
Job Title: IBM Transformation Extender (ITX) Specialist Location: Remote (work from home) Duration: 1+ year Contract Job Description As an ITX Specialist you will be responsible for the end-to-end design of scalable, maintainable, and high-performance integration solutions supporting healthcare payer operations. The ideal candidate has significant domain expertise in healthcare EDI standards (X12, HIPAA, HL7) and a passion for delivering future-ready architectures that meet enterprise interop
Position: - Sr. Business Analyst (PBM Domain and RxCLAIM experience)Location: - RemoteType: - Contract Job Description Perform comprehensive business analysis including requirement elicitation, stakeholder interviews, and gap analysis.Create detailed Business Process Maps (BPMs) and flow diagrams to visualize current and future-state workflows.Work closely with solution architects, QA teams, developers, and business users to ensure proper interpretation of Business processes.Use SQL to query da
Job Title: RxCLAIM SME Location: Remote Duration: Long term Tax Term: W2 Key Technology: RxClaim, PBM Job Responsibilities: Act as a subject matter expert in pharmacy benefit plan design across RxCLAIM or similar adjudication platforms. Create Current state flows for each functional component and their interactions with benefit build process within RxCLAIM and downstream applications. Develop and document plan designs including tier structure, copays, accumulators, exclusions, step therapy,
Role : Technical Product Manager Location : Remote JD: Key Responsibilities Develop and execute product strategies, roadmaps, and technical requirements.Collaborate with engineering, design, and business teams to deliver scalable solutions.Analyze market trends, customer feedback, and competitive landscapes.Translate business objectives into actionable technical and product features.Ensure optimal performance, security, and scalability of products.Manage product lifecycle from concept to deploym
Job Title: Business Analyst Specialty Pharma & PBM Experience Location: Remote (Occasional Travel Required) Employment Type: W2 Contract Pay Rate: $50/hr Company: DVI Technologies Job Description: DVI Technologies is seeking a skilled Business Analyst with a strong background in Specialty Pharmacy systems and Pharmacy Benefit Management (PBM) to join our growing healthcare IT team. The ideal candidate will bring deep domain expertise in healthcare, particularly in specialty pharma operations and
