[Remote] Sr PBM Project Manager
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, and they are seeking a Sr PBM Project Manager to lead complex, multi-vendor healthcare implementations. The role involves managing integrated project plans, ensuring alignment across various stakeholders, and overseeing testing strategies and execution.
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
- PBM, Health Plan / Payer, Managed Care, Healthcare IT experience
- Medicaid & Medicare Part D background
- Claims file, Data Exchange, Eligibility/Enrollment, Formulary / Benefits, PBM Operations, Testing, Vendor management experience
- NCPDP Telecom D.0 and F6, plus Batch knowledge
- NCPDP SCRIPT for e-prescribing knowledge
- Experience with Claim Adjudication platforms (RxClaim, JUDI, Abarca)
- Data analysis & mapping skills
- Requirements documentation skills
- Testing lifecycle knowledge
- Multi-system data flows and integration experience
- Excellent communication and stakeholder management skills
- 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
- Project Management Institute PMP certification
- Experience with both Waterfall and Agile methodologies
- NCPDP transaction standards knowledge
- Industry standard file layouts knowledge
- Claims data reconciliation or financial data flows knowledge
- Pharmacy benefit configuration knowledge
Company Overview
Company H1B Sponsorship