Job Description

Analyze existing NCPDP D.0 transaction processing workflows and identify modifications required for F6 compliance.
Design, develop, test, and implement enhancements to IBM i (AS/400) applications using RPG, RPGLE, SQLRPGLE, CL, and DB2.
Modify claim adjudication, billing, eligibility, and pharmacy transaction processing programs to support NCPDP F6 requirements.
Update database structures, file specifications, and interfaces supporting pharmacy claims.
Develop and maintain inbound and outbound EDI transaction processing.
Perform impact analysis across applications, files, reports, interfaces, and downstream systems.
Create technical design documentation, programming specifications, and implementation plans.
Support system integration testing, troubleshoot and resolve application defects, performance issues, and data anomalies.
Participate in code reviews and ensure adherence to development standards.

RequiredQualifications

TechnicalSkills

PreferredBusiness Knowledge

Experience supporting pharmacy, healthcare, PBM or claims adjudication,
Understanding of EDI transaction processing concepts.
Experience working with healthcare transaction standards and regulatory compliance initiatives.
Ability to translate business requirements into technical solutions.

PreferredQualifications

Experience with NCPDP D.0 and/or NCPDP F6 standards.
Knowledge of pharmacy claims adjudication, PBM, healthcare billing, or pharmacy operations.
Experience with EDI transaction processing and healthcare regulatory projects.
Familiarity with Medicare, Medicaid, or third-party pharmacy claims processing.

Education

Bachelor's degree in Computer Science, Information Systems, Healthcare Information Technology, or related field preferred.
Equivalent combination of education and experience will be considered.

iSeries developer

Quick Overview