Payer EDI Pharmacy Specialist

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The Veterans Health Administration (VHA) Office of Integrated Veteran Care (IVC) Veteran and Family Member Programs (VFMP) oversees five statutory health benefit programs that provide healthcare services to more than 1,000,000 eligible beneficiaries and Veterans in the United States and 6 million service‑connected eligible Veterans around the world.

VFMP partners with hundreds of thousands of non‑VA providers, domestic and international, to ensure timely access to health care and pharmacy services. Essential to VFMP's provider partnership is widely available information about its programs, eligibilities, coverages, and billing, along with bi‑directional provider communication and document exchange supporting health benefits administration.

VFMP requires modern external‑and internal‑facing platforms and automation solutions to manage end‑to‑end health benefits operations for a growing population of users. Further, VFMP requires mechanisms to remain in continued contact with both individuals and the broader Veteran and beneficiary demographics we serve; VFMP programs are lesser known, prone to confusion and misinformation, and require consistent messaging to ensure users have ease of access to care.

Gritter Francona is looking for a Pharmacy Specialist to assist with this upcoming project and initiative.

Requirements

• Serve as the expert on National Council for Prescription Drug Programs (NCPDP) standards within the payer EDI business product team.
• Contribute to the development of VHA Payer EDI NCPDP standards through active participation in integrated project teams.
• Provide insights and guidance to project staff on specific NCPDP technical and functional issues related to pharmacy standards.
• Be an expert in the National Council for Prescription Drug Programs (NCPDP) standards and their application in healthcare data exchange.

Benefits

• 8 years of relevant experience.
• Significant prior experience in healthcare data exchange processes.

Seniority level: Mid‑Senior level

Employment type: Full-time

Job function: Other

Industry: IT Services and IT Consulting

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