ETL Developer - Claims Mgmt

Job Description

Our firm has been engaged by a nationally recognized healthcare benefits platform that specializes in delivering data-driven services and custom benefit solutions. They partner with a wide network of payers, employers, and healthcare providers to ensure quality outcomes and improved operational efficiency. The company has built a reputation for innovation, data integration, and client satisfaction, earning accolades in various industry publications and regional tech awards for operational excellence and digital transformation in healthcare services.

Currently, the company is seeking an ETL Developer with hands-on experience working with PBM data and pharmacy claims feeds. This role is part of the EDI and ETL team that manages claim and eligibility data exchanges between TPAs, PBM vendors, and other healthcare data trading partners. The team is actively building and consolidating integrations as they transition to a modernized claims adjudication platform.

This is a remote, long-term contract role (12+ months) supporting the Central U.S. time zone.

The Role You'll Play

As an ETL Developer, you'll play a pivotal role in architecting and maintaining the systems responsible for processing proprietary healthcare data formats. You'll work across technical and business teams to deliver clean, scalable code that supports proprietary feed formats (not X12), such as CSV or flat files.

Support daily ETL and EDI operations involving PBM and Rx claims feeds.

Partner with external PBM vendors and internal teams to gather, document, and validate feed requirements.

Build and maintain proprietary import/export feeds for claims, eligibility, accumulators, and authorizations using SSIS, SQL Server, and C#.

Analyze healthcare and pharmacy data exchanges to troubleshoot, correct, and optimize feed performance.

Create robust tracking, scheduling, and error-handling mechanisms across FTP/SFTP-based pipelines.

Collaborate in modernizing legacy systems as the organization migrates to a new claims adjudication platform.

Develop technical documentation and provide scoping and effort estimates for integration projects

Background Profile

5–10+ years of experience in backend development and ETL processes.

Strong command of SSIS and SQL Server.

Experience developing, modifying, and deploying ETL pipelines using C# within SSIS.

Must have recent experience working with Rx claims or PBM data sets.

Previous experience working with PBM vendors or adjudication systems.

Familiarity with accumulator data, eligibility feeds, or Rx prior authorization records.

Strong understanding of file formats and mapping (flat files, tab-delimited, CSV).

Experience automating legacy processes and integrating with adjudication platforms like VBA or similar.

Ability to work in cross-functional environments and communicate clearly with technical and business teams.

Experience working with FTP/SFTP and secure data transfers.

Strong troubleshooting, documentation, and version control practices.

Full-time

Fully remote