Data Exchange Lead - Healthcare Interoperability

Transformcap; United States; Hybrid; USD 125,600 - 188,500; Full time

Job summary

Judi Health is seeking a Data Exchange Manager to lead day‑to‑day PBM and TPA data exchange operations. You will oversee teams handling eligibility feeds, claims exchanges, onboarding, and data quality, aligning with clients and internal partners to ensure accurate, secure data movement.

The role requires deep PBM/TPA data expertise, strong analytics, and excellent communication to drive cross‑functional collaboration and operational excellence across HIPAA‑regulated workflows.

Qualifications

• Bachelor’s degree or equivalent experience.
• 5+ years in healthcare data exchange, EDI, PBM or claims administration.
• Leadership experience within a PBM or healthcare setting.
• Knowledge of PBM and TPA data structures and healthcare EDI standards.
• Proficiency in SQL, Excel, and other analytical tools preferred.

Responsibilities

• Lead and develop Data Exchange staff across PBM and TPA operations.
• Oversee healthcare data exchange operations, connectivity, onboarding and production support.
• Manage PBM integrations including eligibility, claims, accumulator, formulary and network data.
• Ensure HIPAA and regulatory compliance across data exchange processes.
• Collaborate with Implementations, Client Services, Product, and Engineering.

Skills

SQL

Excel

Analytical skills

Leadership

Communication

Education

Bachelor’s degree or equivalent

Tools

EDI standards

Job description

Judi Health is seeking a Data Exchange Manager to lead day‑to‑day PBM and TPA data exchange operations. You will oversee teams handling eligibility feeds, claims exchanges, onboarding, and data quality, aligning with clients and internal partners to ensure accurate, secure data movement.

The role requires deep PBM/TPA data expertise, strong analytics, and excellent communication to drive cross‑functional collaboration and operational excellence across HIPAA‑regulated workflows.