AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving health care outcomes for all! We promise to do what’s right, always.
Position Summary:
The ETL Developer is responsible for designing, developing, and maintaining healthcare data exchange solutions with providers, payers, PBMs, and other trading partners. This role works extensively with ANSI X12 and HIPAA-compliant transaction sets to support claims, eligibility, pharmacy, billing, and enrollment processes. The developer partners closely with business teams and technical stakeholders to ensure data quality, regulatory compliance, and reliable system performance while troubleshooting issues and optimizing workflows. In addition, this position contributes to Master Data Management (MDM) initiatives, documents data exchange processes, and provides mentorship and guidance to junior team members.
What you will do:
Data Collaboration and Governance:
- Partner with source systems, data stewards, and technical teams to ensure effective data governance and resolve data quality or technical issues
- Work closely with business teams (claims, eligibility, pharmacy, billing, enrollment, etc.) to gather requirements and implement data exchange solutions that meet operational needs
- Provide mentorship and technical guidance to junior analysts and engineers
Data Exchange Management:
- Design, develop, and maintain data exchange transactions, including maps and workflows, with healthcare providers, payers, PBMs, and other trading partners
- Work with ANSI X12 and HIPAA-compliant transaction sets (834, 837, 835, 270/271, 276/277) and NCPDP pharmacy standards
- Collaborate with PBM partners to optimize prescription, formulary, and claims workflows
Systems Compliance and Performance:
- Ensure compliance with HIPAA, CMS, and other healthcare regulations
- Monitor and improve data exchange performance, reliability, and error-handling processes
- Troubleshoot and resolve issues related to data exchange transactions, connectivity, and partner communications
Master Data and Process Management:
- Support the development of Master Data Management (MDM) plans, including defining processes, policies, requirements, monitoring, and tool selection
- Monitor MDM services to ensure performance, correct errors, and identify areas for improvement
- Collaborate with data remediators, database administrators, network administrators, and software engineers to resolve issues and document data integration processes and system configurations
What you need:
- Bachelor’s degree in Information Technology or equivalent experience
- 5+ years of experience in systems integrations and/or ETL (Extract, Transform, Load), including hands-on work with tools such as Informatica and Microsoft SSIS
- 3+ years of hands-on experience in EDI development, preferably in the healthcare or PBM industry
- Experience with flat file integrations, FTP/SFTP, data cleansing, and transformation
- 5+ years of relational database experience (SQL Server preferred) and 3+ years writing SQL, with emphasis on Master Data Management and data integration methodologies
- Proficiency in mapping tools, scripting languages (e.g., XML, XSLT, SQL), and integration frameworks
- 1–2 years of experience with data warehouse concepts
- Proficiency in ETL standard tools and familiarity with advanced integration topics such as Web APIs, data streams, and cloud integrations (preferred)
- Experience with Power BI
- Strong analytical and problem-solving skills to troubleshoot technical issues, data anomalies, and system integrations
- Ability to work independently or collaboratively within a team environment
- Knowledge of data encryption and security best practices
- Data modeling experience (preferred)
- Excellent written and verbal communication skills
- Healthcare experience, particularly with PBMs, is preferred
What you get:
- To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes
- To work in a culture where people thrive because when OUR team thrives, OUR business thrives
- Competitive compensation, including health, dental, vision and other benefits
Note:
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.
Top Skills
What We Do
AffirmedRx, PBC, is the only Public Benefit Corporation leading the next generation of Pharmacy Benefit Management solutions for employer groups, health plans, hospital groups and other payers. We’re committed to pass through ALL pricing, discounts and rebates we have negotiated with pharma manufacturers and pharmacies to simplify and reduce prescription drug spending. Our goal is for members to have absolute access to the safest and lowest cost medications to help maintain or restore their health. The pharmacy ecosystem is complex with layers of agreements, payment models and fees. We are committed to simplifying pharmacy benefits and helping patients feel good about their benefit provider. AffirmedRx. We're All In.
