Healthcare Applications Developer (NCPDP/EDI/MMIS)

Gainwell Technologies; Pennsylvania; Remote; USD 58,000 - 83,000; Full time

Benefits offered by this job

Generous vacation policy

Educational assistance

401(k) employer match

Comprehensive health benefits

Technical/leadership developmentAcadem

Job summary

Gainwell Technologies is seeking an experienced Healthcare Applications Developer to support the NCPDP F6 implementation for a state Medicaid program. You will lead design, development, testing, and deployment of complex pharmacy claim transactions, collaborating with analysts, architects, and QA teams.

You will translate requirements into scalable technical solutions, validate data mappings with domain experts, and produce thorough technical documentation.

Qualifications

• 5+ years of software development experience, preferably within Medicaid, healthcare, or pharmacy benefit systems.
• Strong hands-on knowledge of NCPDP standards, including D.0 and F6 transaction structures and processing requirements.
• Advanced proficiency in one or more programming languages such as Java, C#, or COBOL, depending on the project environment.
• Demonstrated experience with EDI processing, pharmacy claims, and Medicaid Management Information Systems (MMIS).
• Strong experience with SQL, XML, data transformation tools, system interfaces, and troubleshooting complex data-processing issues.
• Excellent analytical, technical design, debugging, documentation, collaboration, and communication skills.

Responsibilities

• Lead and participate in the full software development lifecycle (SDLC) for the NCPDP F6 implementation, including analysis, design, coding, testing, deployment, and production support.
• Collaborate with business analysts, system architects, quality assurance teams, and technical stakeholders to translate functional requirements into scalable technical solutions.
• Design, develop, and maintain complex application code to ensure accurate and efficient processing of pharmacy claim transactions compliant with NCPDP F6 standards.
• Lead modifications to existing application modules to accommodate updated NCPDP field definitions, segment structures, transaction rules, and state-specific business requirements.
• Partner with EDI, Medicaid, and pharmacy domain experts to validate F6 transaction mappings, layouts, data transformations, and integration points with backend systems.
• Develop and maintain detailed technical documentation, including solution designs, data mappings, interface specifications, code documentation, and system design artifacts.
• Provide technical guidance, conduct code reviews, and support less-experienced developers in applying development standards and project best practices.
• Lead technical support for unit testing, integration testing, user acceptance testing (UAT), defect resolution, deployment, and production stabilization.

Skills

NCPDP standards

Java

C#

COBOL

EDI processing

MMIS

SQL

XML

Analytical skills

Communication skills

Job description

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

As a Healthcare Applications Developer (NCPDP/EDI/MMIS) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Gainwell Technologies is seeking an experienced Professional Developer to support the implementation of the NCPDP F6 standard for one of our state Medicaid pharmacy programs. The selected candidate will provide advanced technical expertise across the analysis, design, development, testing, and deployment of enhancements required to meet NCPDP F6 transaction and data exchange requirements.

Your role in our mission

• Lead and participate in the full software development lifecycle (SDLC) for the NCPDP F6 implementation, including analysis, design, coding, testing, deployment, and production support.
• Collaborate with business analysts, system architects, quality assurance teams, and technical stakeholders to translate functional requirements into scalable technical solutions.
• Design, develop, and maintain complex application code to ensure accurate and efficient processing of pharmacy claim transactions compliant with NCPDP F6 standards.
• Lead modifications to existing application modules to accommodate updated NCPDP field definitions, segment structures, transaction rules, and state-specific business requirements.
• Partner with EDI, Medicaid, and pharmacy domain experts to validate F6 transaction mappings, layouts, data transformations, and integration points with backend systems.
• Develop and maintain detailed technical documentation, including solution designs, data mappings, interface specifications, code documentation, and system design artifacts.
• Provide technical guidance, conduct code reviews, and support less-experienced developers in applying development standards and project best practices.
• Lead technical support for unit testing, integration testing, user acceptance testing (UAT), defect resolution, deployment, and production stabilization.

What We're Looking For

• 5+ years of progressive software development experience, preferably within Medicaid, healthcare, or pharmacy benefit systems.
• Strong hands-on knowledge of NCPDP standards, including D.0 and F6 transaction structures and processing requirements.
• Advanced proficiency in one or more programming languages such as Java, C#, or COBOL, depending on the project environment.
• Demonstrated experience with EDI processing, pharmacy claims, and Medicaid Management Information Systems (MMIS).
• Strong experience with SQL, XML, data transformation tools, system interfaces, and troubleshooting complex data-processing issues.
• Excellent analytical, technical design, debugging, documentation, collaboration, and communication skills.

What You Should Expect In This Role

• Fully Remote Opportunity – Work from anywhere in the U.S.
• Minimal Travel Required – Occasional travel opportunities (0-10%).
• Video cameras must be used during all interviews, as well as during the initial week of orientation.

The deadline to submit applications for this posting is December 30, 2026.

The pay range for this position is $58,200.00 - $83,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.