Principal PBM Data Integration Lead
About The Position
Prescryptive is a healthcare technology company enabling a direct access marketplace for prescription drugs. The Principal PBM Data Integration Lead is a hands-on technical expert in PBM data integrations who also owns program delivery. The role profiles, maps, and validates claims, eligibility, and accumulator data; designs integration architecture with engineering; and manages timelines, risks, and vendor dependencies. The lead remains close to the data by writing SQL, resolving discrepancies, and troubleshooting production issues, while directing teams responsible for much of the day-to-day work. The position owns end-to-end delivery of benefit data integrations, including coordination of vendors and internal teams, integration testing, UAT, implementation readiness, migration and rollback planning, and post-deployment support. It also communicates findings to technical and non-technical stakeholders and maintains system documentation and operational procedures. The projected annual salary range is $148,000–$205,000. Prescryptive considers relevant experience, internal equity, and location when preparing an offer.
Requirements
- 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.
Nice To Haves
- Experience with a pharmacy benefits adjudication platform.
- Cloud experience, ideally Microsoft Azure, in healthcare data environments.
- Familiarity with C#, Java, JavaScript, Python, or R.
Responsibilities
- Profile, map, and validate claims, eligibility, accumulator, and encounter data across multiple sources.
- Resolve daily eligibility and accumulator discrepancies arising from file imports and monthly reconciliations.
- 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 system and data failures.
- Partner with engineering and architects to develop scalable, compliant 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 vendor data formats and constraints between the groups.
- Plan and coordinate integration testing, UAT, and implementation readiness, including data migration, rollback planning, and post-deployment support.
- Communicate findings and recommendations to technical and non-technical stakeholders.
- Maintain system documentation and operational procedures.
Benefits
- Flexible time off, including 12 paid holidays.
- 401(k) match.
- 100% employer-provided medical, dental, and vision premiums.
- Company contribution to a Health Savings Account.
- Stock options.
- Opportunity to grow alongside an early-stage company.
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What This Job Offers
Job Type
Full-time
Career Level
Principal
