EDI Integrations Developer

Summary

OptiMed Health Partners is dedicated to optimizing health outcomes through personalized care and has been serving patients for over 30 years. The EDI Integrations Developer will ensure accurate and efficient data exchange within the pharmacy ecosystem, leading EDI implementations and translating complex requirements into effective integrations.

Responsibilities

• Lead new EDI feed implementations from discovery through production deployment, partnering with Account Managers during client onboarding to capture requirements for eligibility files, claims transactions, accumulator feeds, and specialty pharmacy data exchanges
• Translate business, compliance, and HIPAA requirements into technical specifications and working integrations within the Talend platform
• Deploy integrations to production pharmacy claims adjudication environments with monitoring, logging, and alerting
• Serve as the primary technical point of contact for health plan, PBM, employer group, and pharmaceutical manufacturer integrations
• Lead requirements-gathering conversations with external trading partners, setting expectations and timelines for technical and non-technical stakeholders
• Troubleshoot and resolve feed issues caused by upstream changes, data quality issues, or system defects, while communicating updates to internal teams and clients
• Assist with group and plan configuration setup in pharmacy systems to ensure accurate eligibility, formulary, and benefits data flow
• Fulfill ad hoc data requests and reporting needs to support Account Management, Clinical Operations, and client satisfaction
• Analyze inbound and outbound files for adherence to HIPAA X12 standards (270/271, 834, 835, 837, NCPDP D.0) and trading partner specifications
• Migrate legacy Python-based ETL and EDI jobs into Talend to improve system reliability and maintainability
• Design and enhance monitoring dashboards to detect feed failures and data anomalies
• Establish and maintain secure file transport connections (SFTP/FTPS) with trading partners, including testing and go-live coordination
• Create and maintain technical documentation such as workflow diagrams, feed specifications, and operational runbooks
• Work cross-functionally with IT, Pharmacy Operations, Clinical Services, Finance, Billing, and Account Management teams
• Contribute to data stewardship and master data management initiatives
• Provide training to end users on new integrations and tools as needed

Skills

• 1+ years of experience in a programming, ETL, or integrations role with examples of completed projects
• 1+ years of experience working with SQL (PostgreSQL strongly preferred), including writing queries, understanding schema design, and working with data
• Ability to read and interpret HIPAA X12 EDI specifications and implementation guides
• Ability to work with multiple databases, file formats, and communication standards
• Basic experience working with secure file transfer protocols such as SFTP and FTPS
• Strong problem solving skills with the ability to troubleshoot complex data and system issues
• Ability to manage multiple projects and integrations simultaneously in a fast paced environment
• Strong communication skills with the ability to engage both technical and non technical stakeholders
• Ability to lead requirements discussions and translate business needs into technical solutions
• Attention to detail and commitment to data accuracy and compliance
• Self directed with the ability to work independently while knowing when to collaborate
• Strong organizational and time management skills
• Collaborative mindset with cross functional team engagement
• Adaptability in dynamic environments with changing priorities
• Growth mindset with openness to feedback and continuous learning
• Ability to innovate and develop creative technical solutions
• Strong documentation and knowledge sharing practices
• A computer science degree is preferred but not required. Equivalent work experience and demonstrated technical ability are valued
• 1+ years of experience working with Python in an ETL, automation, or scripting context preferred
• Hands on experience with Talend or a comparable ETL or integration platform preferred
• Experience in healthcare IT, pharmacy systems, PBM operations, or EDI workflows preferred
• Familiarity with pharmacy specific transactions (NCPDP, 834 enrollment, 835 remittance, 837 claims) preferred
• Experience with CPR+ or similar pharmacy claims adjudication platforms preferred
• Experience developing end to end solutions from backend and database design to user interface preferred

Qualifications

Must Haves

• 1+ years of experience in a programming, ETL, or integrations role with examples of completed projects
• 1+ years of experience working with SQL (PostgreSQL strongly preferred), including writing queries, understanding schema design, and working with data
• Ability to read and interpret HIPAA X12 EDI specifications and implementation guides
• Ability to work with multiple databases, file formats, and communication standards
• Basic experience working with secure file transfer protocols such as SFTP and FTPS
• Strong problem solving skills with the ability to troubleshoot complex data and system issues
• Ability to manage multiple projects and integrations simultaneously in a fast paced environment
• Strong communication skills with the ability to engage both technical and non technical stakeholders
• Ability to lead requirements discussions and translate business needs into technical solutions
• Attention to detail and commitment to data accuracy and compliance
• Self directed with the ability to work independently while knowing when to collaborate
• Strong organizational and time management skills
• Collaborative mindset with cross functional team engagement
• Adaptability in dynamic environments with changing priorities
• Growth mindset with openness to feedback and continuous learning
• Ability to innovate and develop creative technical solutions
• Strong documentation and knowledge sharing practices

Nice to Haves

• A computer science degree is preferred but not required. Equivalent work experience and demonstrated technical ability are valued
• 1+ years of experience working with Python in an ETL, automation, or scripting context preferred
• Hands on experience with Talend or a comparable ETL or integration platform preferred
• Experience in healthcare IT, pharmacy systems, PBM operations, or EDI workflows preferred
• Familiarity with pharmacy specific transactions (NCPDP, 834 enrollment, 835 remittance, 837 claims) preferred
• Experience with CPR+ or similar pharmacy claims adjudication platforms preferred
• Experience developing end to end solutions from backend and database design to user interface preferred