Senior PBM Data Integration Architect

Prescryptive Health, Inc.; United States; À distance; USD 148 000 - 205 000; Plein temps

Avantages offerts par ce poste

Flexible time off

12 paid holidays

401k match

Employer-provided medical, dental, and

Vision premiums

Health Savings Account contributions

Stock options

Résumé du poste

Prescryptive Health, Inc. is seeking a hands‑on PBM data integration expert who owns program delivery.

You will profile, map, and validate claims, eligibility, accumulator, and encounter data, and design integration architecture with engineering while managing timelines, risks, and vendor dependencies. You will stay close to the data—writing SQL, resolving discrepancies, and troubleshooting production issues—while directing teams handling day‑to‑day work and coordinating end‑to‑end data

Qualifications

• Bachelor’s degree in Statistics, Mathematics, Engineering, Computer Science, Business Analytics, or a related quantitative field.
• At least 10 years of hands‑on technical experience with data systems, SQL, and integrations.
• At least 6 years of direct PBM or pharmacy claims processing experience, including deep knowledge of benefit configuration, adjudication logic, eligibility, and accumulator integrations.
• Advanced SQL proficiency, including complex querying and data investigation.
• Experience supporting eligibility and accumulator reconciliation processes.
• Experience designing scalable data architecture for healthcare data systems.
• Experience managing delivery timelines, risks, and dependencies, and coordinating integration testing and UAT.
• Working knowledge of the ANSI/NCPDP Telecommunication Standard and PBM or TPA claims processing.
• Hands‑on experience with ETL, secure file transfer (SFTP/PGP), and job scheduling and alerting tools.
• Ideally you will also have Experience with a pharmacy benefits adjudication platform.
• Cloud experience, ideally Microsoft Azure, in healthcare data environments.
• Familiarity with C#, Java, JavaScript, Python, or R.

Responsabilités

• Profile, map, and validate complex claims, eligibility, accumulator, and encounter data across multiple sources, resolving daily discrepancies.
• Write and execute advanced SQL for investigation, validation, regression testing, and special data loads.
• Lead cross‑functional root‑cause investigation and remediation of production issues and anticipate failures.
• Partner with engineering and architects on scalable integration architecture for claims, eligibility, and accumulators.
• Own end‑to‑end delivery of benefit data integrations, including timelines, milestones, risks, dependencies, and executive reporting.
• Coordinate with external vendors and internal engineering, translating data formats and constraints.
• Plan and coordinate integration testing, UAT, and implementation readiness, including data migration and post‑deployment support.
• Communicate findings to technical and non‑technical stakeholders; maintain system documentation.

Connaissances

SQL

PBM claims processing

Data integration

ETL

SFTP/PGP

Job scheduling

Azure Cloud

C#

Java

Python

Data profiling

Root cause analysis

Formation

Bachelor’s degree in Statistics, Mathematics, Engineering, Computer Science, Business Analytics, or related quantitative field

Outils

ETL tools

SFTP/PGP

Data migration tooling

Description du poste

Prescryptive Health, Inc. is seeking a hands‑on PBM data integration expert who owns program delivery.

You will profile, map, and validate claims, eligibility, accumulator, and encounter data, and design integration architecture with engineering while managing timelines, risks, and vendor dependencies. You will stay close to the data—writing SQL, resolving discrepancies, and troubleshooting production issues—while directing teams handling day‑to‑day work and coordinating end‑to‑end data