[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