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[Remote] PBM Project Manager

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. Pyramid Consulting Group, Inc is a company focused on healthcare solutions. They are seeking a PBM Project Manager to lead complex, multi-vendor healthcare implementations and ensure alignment across workstreams, timelines, and deliverables.

Responsibilities

  • Lead complex, multi-vendor healthcare implementations, ensuring alignment across workstreams, timelines, and deliverables
  • Develop and manage integrated project plans, including dependencies, risks, issues, and decision tracking (RAID)
  • Drive cross-functional coordination across business, IT, operations, and external vendors
  • Oversee testing strategy and execution, including UAT coordination across multiple systems and partners
  • Manage program governance, status reporting, and executive-level communications
  • Proactively identify and mitigate risks to maintain schedule, quality, and regulatory alignment
  • Support go-live planning, dual-use readiness, and command center execution
  • Support delivery of defined workstreams within a larger program
  • Maintain detailed project plans, tracking milestones, dependencies, and status updates
  • Manage RAID logs and ensure timely escalation of risks and issues
  • Coordinate across internal teams and vendors to support execution
  • Prepare status reporting and support governance forums
  • Track action items and ensure follow-through against agreed timelines

Skills

  • PBM/health plan experience
  • NCPDP D.0/F6 knowledge
  • Experience delivering in multi-vendor implementations
  • Medicaid & Medicare Part D background
  • Claims file, Data Exchange, Eligibility/Enrollment, Formulary / Benefits, PBM Operations, Testing, Vendor management
  • NCPDP Telecom D.0 and F6, plus Batch
  • NCPDP SCRIPT for e-prescribing
  • Claim Adjudication platforms (RxClaim, JUDI, Abarca)
  • Data analysis & mapping
  • Requirements documentation
  • Testing lifecycle
  • Multi system data flows and integration
  • Excellent communication and stakeholder management skills, with the ability to influence and build strong working relationships
  • Proven ability to deliver results on schedule and at required quality standards
  • Strong problem-solving and sound decision-making capabilities
  • Ability to influence, negotiate, and drive alignment across stakeholders
  • Ability to research subject matter and proactively share best practices and lessons learned with clients and team
  • Lead complex, multi-vendor healthcare implementations, ensuring alignment across workstreams, timelines, and deliverables
  • Develop and manage integrated project plans, including dependencies, risks, issues, and decision tracking (RAID)
  • Drive cross-functional coordination across business, IT, operations, and external vendors
  • Oversee testing strategy and execution, including UAT coordination across multiple systems and partners
  • Manage program governance, status reporting, and executive-level communications
  • Proactively identify and mitigate risks to maintain schedule, quality, and regulatory alignment
  • Support go-live planning, dual-use readiness, and command center execution
  • Support delivery of defined workstreams within a larger program
  • Maintain detailed project plans, tracking milestones, dependencies, and status updates
  • Manage RAID logs and ensure timely escalation of risks and issues
  • Coordinate across internal teams and vendors to support execution
  • Prepare status reporting and support governance forums
  • Track action items and ensure follow-through against agreed timelines
  • Project Management Institute PMP certification
  • Experience with both Waterfall and Agile methodologies

Company Overview

  • Pyramid Consulting Group is a recognized leader in today's Information Technology Staffing Industry. It was founded in 1996, and is headquartered in Gibsonia, Pennsylvania, USA, with a workforce of 51-200 employees. Its website is http://www.pyramid-group.com.
  • Company H1B Sponsorship

  • Pyramid Consulting Group, Inc has a track record of offering H1B sponsorships, with 1 in 2023, 1 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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