Systems & Integration Manager

Independent Health Association•Buffalo, NY

8d•Hybrid

About The Position

The Systems and Integration Manager is responsible for managing, optimizing, and continuously improving the pharmacy management system, third-party integrations, and related technology platforms that support specialty pharmacy operations. The role serves as the primary liaison among pharmacy operations, IT, billing and reimbursement teams, and vendors to ensure technology supports business needs, regulatory requirements, workflow efficiency, and patient service. The manager leads system configuration and workflow development, automation, EDI and ORTF configuration and delivery, 835/payment file implementation, enhancement requests, issue resolution, and system-related projects. The position identifies technology opportunities with strong return on investment while maintaining system integrity, data accuracy, compliance, and operational efficiency. It is a hybrid position requiring onsite attendance at the Williamsville location. Immigration or work visa sponsorship is not provided. Hiring compensation range is $70,000–$90,000 annually; associates may also be eligible for a scorecard incentive, benefits, and paid time off.

Requirements

Bachelor’s degree required; an additional four years of experience may be considered in lieu of a degree.
Five years of experience working in specialty pharmacy, healthcare IT, or with pharmacy management systems.
Understanding of pharmacy claims, billing, reimbursement, and payer processes.
Strong understanding of specialty pharmacy workflows.
Experience with system testing, workflow development, automation, and implementation.
Strong project and program management and organizational skills.
Ability to work effectively with technical and non-technical teams.
Strong Microsoft Office skills.
Excellent verbal, written, and interpersonal communication skills.
Proven examples of displaying the Reliance values: Collaborative, Accessible, Results-Oriented, Empowering, and Supportive.
Onsite attendance is required at the Williamsville location as part of the hybrid position.

Nice To Haves

Experience configuring or administering pharmacy software.
Experience with EDI transactions and 835 files.
Experience with ScriptMed.

Responsibilities

Serve as the primary business owner and subject-matter expert for the pharmacy management system.
Maintain system configuration, workflows, business rules, protocols, queues, user functionality, documentation, configuration specifications, and change history.
Evaluate system capabilities and identify opportunities to improve efficiency, accuracy, and scalability.
Partner with IT and software vendors on system upgrades, releases, testing, and issue resolution.
Manage the organization's transition to NCPDP F6 pharmacy claims standards, including requirements gathering, configuration, testing, vendor coordination, implementation, and ongoing claims-management support.
Develop and enforce procedures for user provisioning, role assignment, access reviews, and termination workflows; oversee periodic user-permission audits and collaborate on role-based access controls and security standards.
Design and implement automation, alerts, and workflow enhancements; analyze workflows for automation and standardization opportunities and monitor performance.
Own the pharmacy system support-ticket process, prioritize and coordinate issue resolution, track recurring issues and root causes, establish escalation and communication processes, and use ticket trends to identify improvements.
Manage system enhancement requests from requirements through implementation; translate business requirements into system solutions and develop project plans, timelines, testing requirements, and implementation plans.
Assess the operational impact of system changes and coordinate training and communication.
Coordinate implementation, configuration, testing, and maintenance of EDI transactions with external partners; work with payers, clearinghouses, vendors, billing, finance, and IT to resolve transaction issues.
Manage setup and troubleshooting of 835 Electronic Remittance Advice files and related payment and reconciliation processes.
Design, configure, implement, test, and support 837 electronic claim transactions (837P, 837I, and applicable specialty pharmacy medical billing formats) for accurate and compliant payer submissions.
Support other electronic transactions as applicable, including eligibility, claims, acknowledgments, and remittance transactions; validate transaction mapping and data transmission and troubleshoot rejected, missing, or incorrectly formatted transactions.
Bridge pharmacy operations and technical teams, communicating technical issues and solutions to non-technical stakeholders.
Develop test plans and scenarios, conduct or coordinate regression testing, coordinate user acceptance testing, and validate functionality before production implementation.
Ensure system changes support applicable pharmacy, payer, HIPAA, security, and regulatory requirements; coordinate implementation and post-implementation monitoring.