Project Manager: Pharmacy Systems & NCPDP Implementation

Job Summary:

Senior Consultant Advisor, Oracle Health Julie Easley is recruiting this position.

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Job title: Project Manager for Pharmacy Systems & NCPDP Implementation

Number of roles: Two positions

Duration: 18 months contract + extensions

Work location: Hybrid role, travel will be to Arkansas

Start date: ASAP

We are seeking a highly experienced and strategic Project Manager to lead the implementation of the National Council for Prescription Drug Programs (NCPDP) Telecommunication Standard Version F6 across our pharmacy systems infrastructure.

This critical role involves managing a large-scale, enterprise-wide transformation program to modernize our electronic retail pharmacy transactions. The NCPDP Telecommunication Standard Version F6 is the HIPAA-mandated standard replacing the older Version D.0, defining the essential record layout and practical guidelines for real-time data exchange between pharmacies and payers for transactions such as claim billing, eligibility verification, and coordination of benefits. The goal of this modernization is to streamline pharmacy workflows, improve coordination of benefits processing, and enhance patient safety through more robust data fields for high-cost drugs and controlled substance claims.

The ideal candidate will bridge the gap between technical engineering teams, product owners, billing/financial operations, and executive leadership, ensuring compliance with federal healthcare regulations and successful vendor integrations.

Key Responsibilities:

• Program Leadership: Lead the planning, execution, and final delivery of the NCPDP Version F6 implementation project across all relevant enterprise systems.
• Regulatory Compliance: Ensure all system implementations adhere strictly to HIPAA mandates, as well as CMS, Medicaid, and Medicare regulations.
• Cross-Functional Management: Manage diverse, cross-functional teams including software engineers, product managers, billing specialists, and data architects.
• Infrastructure Modernization: Drive technical projects related to infrastructure modernization and large-scale SaaS implementations necessary to support the new data standards.
• Stakeholder Communication: Serve as the primary communication liaison, effectively articulating project status, risks (RAID tracking), and technical challenges to executive leadership and technical associates alike.
• Vendor Integration: Oversee the integration of third-party systems and external vendors, managing external relationships and ensuring seamless payer connectivity.
• Process Improvement: Identify and implement process improvements within existing workflows, leveraging insights to enhance efficiency in billing, receivables, and financial operations.
• Governance & Compliance: Establish robust program governance, manage risk logs, track compliance metrics, and ensure adherence to best practices (PMP/Six Sigma methodologies).

Required Qualifications & Experience:

• PBM Implementation Experience: Proven track record managing complex implementations within a Pharmacy Benefit Management (PBM) environment.
• Healthcare Domain Expertise: Deep strength and knowledge of the healthcare industry, specifically concerning healthcare data, EDI, and claims processing.
• NCPDP Expertise: Extensive experience with pharmacy claims processing, the NCPDP standard, and payer connectivity.
• Regulatory Experience: Strong working knowledge of relevant regulatory bodies and mandates (HIPAA, CMS, Medicaid/Medicare).
• Project Management Certifications: PMP or formal PM certification is required; Six Sigma certification is a plus.
• Enterprise-Scale Transformation: Experience successfully leading enterprise-scale technology transformations.
• Communication Skills: Exceptional communication skills tailored for executive-level audiences as well as engineering/associate-level teams.
• Financial Operations Exposure: Familiarity with billing, receivables, and financial operations within a healthcare context.

To learn more about this and other positions, contact Julie Easley at or julie.easley@healthcareitleaders.com. Healthcare IT Leaders is a national leader in IT workforce solutions, connecting healthcare provider, payer and life sciences organizations with experienced technology talent for consulting and full-time hiring. For more information, visit us on the web at www.healthcareitleaders.com.