Pharmacy Developer Software Engineer II

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

Responsible for one or more of the following: leading, planning and controlling projects; defining customer requirements; analyzing and designing solutions to business problems; programming new systems; maintaining existing systems; coordinating creation and change of data structures; integrating vendor packages; researching new tools, technologies, or platforms; thoroughly testing all program logic; creating test plans; and supporting the customer. When analyzing and designing solutions, the incumbent is responsible for developing cost effective automated solutions that meet business requirements. To successfully accomplish this goal, close customer contact is required. The incumbent reviews current procedures/systems and proposes recommended solutions and alternatives to satisfy customer requests for system enhancements.

Responsibilities And Qualifications

• Analyze and research business problems to determine the impact on existing business and IT systems and procedures, as well as the feasibility of automation.
• Conforms with PMO guidelines and procedures when developing IT solutions to defined business problems using structured methodologies. Conducts meetings with customers to ensure requirements are clearly defined and adequately satisfied.
• Designs innovative solutions using emerging and existing technologies for business problems and determines feasibility and practicality of implementation within current or future environments.
• Prepares test data and conducts program and system tests to ensure compliance. Assists customers in establishing acceptance criteria and effectiveness of proposed solutions.
• Maintains knowledge of the department’s programming languages and tools, coding and design techniques, data base management systems, processing platforms and emerging technologies through continued education.
• Analyzes functional and technical aspects of existing systems to identify areas where improvement can result in cost savings and improved quality and service.
• Develops and maintains programs or systems and all related elements (e.g., scripts, stored procedures, documentation, maintenance schedules, etc.).
• Create and maintains all documentation for assigned applications in order to establish standards for configuration and enhancements within the application.
  
  

Experience And Skills

• Familiarity with the healthcare insurance industry.
• Managed care experience and specific knowledge and training in the workflow for dispensing of pharmacy prescriptions including end to end adjudication process, pharmacy benefits, pharmacy formulary, clinical review, rebates, cost containment strategies, Medicare Part D rules and compliance requirements.
• Knowledge of pharmacy industry and experience working with a Pharmacy Benefit Manager
• Knowledge and understanding of medical and pharmaceutical terminology and practices.
• Working experience with Informatica PowerCenter, IDMC, or CDI-PC or equivalent ETL software, to design and architect integrated solutions
• Working experience with SQL, Shell Scripts and Stored procedures
• Working knowledge of database management technologies, data modeling practices and database platforms (e.g., Oracle, SQL Server) and data warehouse concepts
• Working knowledge of electronic drug data and clinical information from Medi-Span and Redbook
• Strong communication skills: ability to effectively communicate (verbally and in writing) with all levels of plan personnel and external contacts with professionalism (courtesy, persuasion, and tact).
• Strong organizational skills to prioritize workload, monitor project activities, and manage time effectively in an ever-changing health care environment.
• Ability to manage rapidly changing priorities and meet stringent deadlines with minimal supervision.
• Strong interpersonal and team skills with ability to work and interact with Management level staff both within and outside of Pharmacy Services to manage benefit, group/member, or operation issues.
• Ability to provide off-hours assistance to support customers and I/T initiatives.
• Ability to work independently and/or as a member of a project team.
  
  

Education

• Minimum of three years I/T experience; or an equivalent combination of experience and education.
• Bachelor’s degree in Computer Science, Business Administration or Healthcare Administration in a health science field and previous Pharmacy Benefits Management (PBM) experience.
  
  

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.

And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.