Qa. pbm jobs | Dice.com

Remote

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13d ago

QA PBM REMOTE 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, regression coverage, and production readiness. The ideal candidate has strong pharmacy claims testing experience, working knowledge of NCPDP D.0, the abilit

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Contract, Third Party

Depends on Experience

QA Lead/Manager- PBM Claims Processing -Remote

Remote

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6d ago

Required Qualifications 15+ years of software quality assurance experience, including hands-on test design and execution. 5+ years of QA leadership or management experience. Strong experience supporting PBM claims processing systems. Deep understanding of SDLC, Agile execution, test estimation, risk-based testing, and release management. Ability to define and manage quality metrics, dashboards, and team performance indicators. Strong analytical, communication, stakeholder management, and proble

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Contract, Third Party

Depends on Experience

Senior Synon & Cobol400 Developer

Remote

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2d ago

Job Description - Design, develop, modify, and enhance applications using SYNON/COOL 2E, COBOL400, CL/400, CLLE, and DB2/400. - Develop and support RxCLAIM / pharmacy claims adjudication functionality and related business processes. - Analyze and enhance complex claim processing logic, including business rules and system workflows. - Develop and maintain integrations with downstream healthcare and PBM systems. - Perform major enhancements and modifications to existing healthcare applications. -

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Contract

Product Quality Engineer - Battery Pack - BMS

Novi, Michigan

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Today

ESSENTIAL DUTIES AND RESPONSIBILITIES: Lead Advanced Product Quality Planning (APQP) for pack and BMS programs, representing Quality at program gate and design reviews (e.g., PDR/CDR) and driving quality deliverables to program milestones.Serve as a significant contributor to Design FMEAs (DFMEA) led by Design Engineering and Process FMEAs (PFMEA) led by Manufacturing Engineering - bringing quality, test, and field data to the analysis, challenging severity/occurrence/detection ratings, and ver

Full-time

Quality Business Area Manager

Huntsville, Alabama

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Today

Description The Defense sector at Leidos has an opening for a Quality Business Area Manager Role! Daily duties and/or specific job responsibilities. Establish and maintain a quality culture committed to performance excellence, customer mission, and Leidos values/requirements.Plan and manage quality engineering & control activities to support Sr Program Quality Manager and business area initiatives to achieve mission assurance and program performance excellence.Support the development, deploymen

Full-time

USD 116,350.00 - 210,325.00 per year

Business Analyst – Pharmacy Claims

Remote

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Yesterday

What youll do Gather, analyze and translate pharmacy claims workflow requirements into Business Requirements Documents (BRDs), Functional System Specifications (FSDs) and user stories with clear acceptance criteria. Map transaction data fields across NCPDP Version F6 standards, including Eligibility Verification (E1), Claim Billing (B1), Claim Reversal (B2), Claim Rebill (B3) and Predetermination of Benefits (D1). Analyze field-level changes between NCPDP D.0 and F6, including: expanded field le

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Contract

Depends on Experience

Data Analytics, Business Systems Analyst IV

Remote

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Today

Exemption Status: United States of America (Exempt) $95,717 - $132,808 - $169,898 "Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate." This position is not eligible fo

Full-time

USD 95,717.00 - 132,808.00 per year

Product Analyst

Remote or Hybrid

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Today

Product Analyst first, data analyst second ? Will sit within an Agile/Scrum product team and work closely with Product Owners, engineering, QA, and business partners. Story refinement is a major part of the job ? needs experience developing/refining stories and acceptance criteria. SQL is important ? candidate needs to personally query/investigate data. Uses data to help answer product questions, investigate issues, and validate delivered outcomes. Needs enough technical aptitude to understand s

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Contract

$55-$65

Lead Director, Software Development Engineering (Member Eligibility Services)

Remote or Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. CVS Health's exciting and impactful Claims Adjudication

Full-time

USD 144,200.00 - 288,400.00 per year

Lead Director - Data Scientist - Forecasting Accuracy and Analytical insights for Underwriting

Remote or Texas

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary The Lead Director, Lead Director - Dat

Full-time

USD 144,200.00 - 288,400.00 per year

Technical Analyst - IntelliScript (Remote)

Remote or Brookfield, Wisconsin

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Today

What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance, health IT and life sciences clients. We are a business unit within Milliman, Inc., a respected consultancy with offices around the world. IntelliScript attracts top candidates with its innovative, collabo

Full-time

USD 65,200.00 - 131,905.00 per year

PBM BUSINESS ANALYST

Remote

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13d ago

PHARMACY BENEFITS MANAGEMENT PBM SME and BUSINESS ANALYST Remote 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 Conduent 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 Teste

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Third Party, Contract

Depends on Experience

PLM QA Analyst

Seattle, Washington

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15d ago

Job Type: Contract Duration: 6 Months Location: Seattle, WA Experience: 68 Years Job Summary We are seeking an experienced PLM QA Analyst with strong knowledge of Product Lifecycle Management, specification management, formulation processes, and quality assurance within the Food & Beverage industry. The ideal candidate will have experience with SpecRight or similar PLM/specification platforms and will be responsible for testing and validating product, ingredient, formulation, packaging, n

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Contract, Third Party

$59 - $63

Business Systems Analyst

Hybrid in San Diego, California

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7d ago

Summary As the liaison between internal and external clients and IT, you will gather business needs, translate them into functional requirements, and drive software enhancements from design through release. Key Responsibilities Interview end users and clients to define requirements for complex software changesTurn business requirements into functional specifications: system requirements, flow charts, report mock-ups, and business rulesFacilitate design sessions between business and technical tea

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Contract

Depends on Experience

Synon Developer

Remote

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22d ago

Role : Senior Synon DeveloperLocation : Remote Job Description Design, develop, modify, and enhance applications using SYNON/COOL 2E, COBOL400, CL/400, CLLE, and DB2/400.Develop and support RxCLAIM / pharmacy claims adjudication functionality and related business processes.Analyze and enhance complex claim processing logic, including business rules and system workflows.Develop and maintain integrations with downstream healthcare and PBM systems.Perform major enhancements and modifications to ex

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Third Party, Contract

Depends on Experience

Healthcare IT Delivery Manager

Matawan, New Jersey

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Today

Position OverviewWe are seeking an experienced IT Delivery Manager to lead the successful delivery of enterprise application development projects within a healthcare organization. This individual will oversee multiple technology initiatives, manage cross-functional development teams, and ensure applications and solutions are delivered on time, within budget, and in alignment with business objectives. The ideal candidate will bring a strong background in application development delivery, Agile me

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Contract

Depends on Experience

Senior Network Pricing Consultant

Eden Prairie, Minnesota

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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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad

Full-time

USD 60,200.00 - 107,400.00 per year

Senior Data Analyst - Archimedes

Remote or Earth City, Missouri

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Today

Company Archimedes About Us Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmac

Full-time

Senior QA Test Engineer with Healthcare Claims, Medicaid Medicare or PBM (Pharmacy Benefits)

Remote

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2d ago

Job Descriptions: About Infinite: InfiniteisagloballeaderindigitalengineeringandITservices,withover20yearsofexperiencedrivingdigitaltransformation.WepartnerwithleadingFortune1000companiestodeliverinnovative,scalabletechnologysolutionsthatacceleratebusinessoutcomes. Withdeepexpertiseintelecommunications,healthcare,banking,andfinance,Infinitehelpsorganizationsoptimizeandmodernizetheirtechnologylandscapestoachievelong-termgrowthandefficiency. Title : IT Helpdesk Engineer Location : 3800 Kilroy Air

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Full-time

Depends on Experience

Principal Software Development Engineer (PBM AI Solutions)

Remote or Buffalo Grove, Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role Summary At CVS Health , you'll be working with a t

Full-time

USD 144,200.00 - 288,400.00 per year