Edi Account Manager Jobs in Michigan (NOW HIRING)

Who We Are:

OptiMed Health Partners optimizes health outcomes and quality of life through personalized and coordinated care. We have been serving patients for over 30 years with a focus on high-quality care in retail pharmacy, specialty pharmacy, and infusion services. The OptiMed Vision reimagines healthcare solutions to achieve unsurpassed value. Our results-oriented culture fosters learning, providing growth opportunities for our employees and exceptional care for our patients in all 50 states.

The Impact of this Role:

The EDI Integrations Developer plays a critical role in ensuring the accuracy, reliability, and efficiency of data exchange across OptiMed’s pharmacy and PBM ecosystem. In specialty pharmacy and PBM, data accuracy is essential, as every eligibility file, claims transaction, and enrollment feed directly impacts patient access to critical medications.

This role serves as the technical backbone of integration workflows, enabling seamless communication between OptiMed, health plans, PBM partners, employer groups, and pharmaceutical manufacturers. By owning and optimizing data pipelines, the EDI Integrations Developer ensures that patients receive timely access to life-changing therapies while supporting internal operational efficiency.

Through collaboration with internal teams and external partners, this role translates complex technical and compliance requirements into real-world solutions, contributing directly to improved patient outcomes and organizational growth.

What You’ll be Doing:

• Lead new EDI feed implementations from discovery through production deployment, partnering with Account Managers during client onboarding to capture requirements for eligibility files, claims transactions, accumulator feeds, and specialty pharmacy data exchanges
• Translate business, compliance, and HIPAA requirements into technical specifications and working integrations within the Talend platform
• Deploy integrations to production pharmacy claims adjudication environments with monitoring, logging, and alerting
• Serve as the primary technical point of contact for health plan, PBM, employer group, and pharmaceutical manufacturer integrations
• Lead requirements-gathering conversations with external trading partners, setting expectations and timelines for technical and non-technical stakeholders
• Troubleshoot and resolve feed issues caused by upstream changes, data quality issues, or system defects, while communicating updates to internal teams and clients
• Assist with group and plan configuration setup in pharmacy systems to ensure accurate eligibility, formulary, and benefits data flow
• Fulfill ad hoc data requests and reporting needs to support Account Management, Clinical Operations, and client satisfaction
• Analyze inbound and outbound files for adherence to HIPAA X12 standards (270/271, 834, 835, 837, NCPDP D.0) and trading partner specifications
• Migrate legacy Python-based ETL and EDI jobs into Talend to improve system reliability and maintainability
• Design and enhance monitoring dashboards to detect feed failures and data anomalies
• Establish and maintain secure file transport connections (SFTP/FTPS) with trading partners, including testing and go-live coordination
• Create and maintain technical documentation such as workflow diagrams, feed specifications, and operational runbooks
• Work cross-functionally with IT, Pharmacy Operations, Clinical Services, Finance, Billing, and Account Management teams
• Contribute to data stewardship and master data management initiatives
• Provide training to end users on new integrations and tools as needed

Who You’ll be Working With:

This role collaborates with IT, Pharmacy Operations, Clinical Services, Finance, Billing, and Account Management teams. The position also works closely with external partners including health plans, PBMs, employer groups, and pharmaceutical manufacturers.

Skills and Experience You’ll Bring to the Table:

• A computer science degree is preferred but not required. Equivalent work experience and demonstrated technical ability are valued.
• 1+ years of experience in a programming, ETL, or integrations role with examples of completed projects
• 1+ years of experience working with SQL (PostgreSQL strongly preferred), including writing queries, understanding schema design, and working with data
• 1+ years of experience working with Python in an ETL, automation, or scripting context preferred
• Ability to read and interpret HIPAA X12 EDI specifications and implementation guides
• Hands on experience with Talend or a comparable ETL or integration platform preferred
• Experience in healthcare IT, pharmacy systems, PBM operations, or EDI workflows preferred
• Familiarity with pharmacy specific transactions (NCPDP, 834 enrollment, 835 remittance, 837 claims) preferred
• Experience with CPR+ or similar pharmacy claims adjudication platforms preferred
• Supporting technical skills including MS Excel, Bitvise, PowerShell or Bash scripting, and JavaScript, HTML, CSS (a plus)
• Ability to work with multiple databases, file formats, and communication standards
• Experience developing end to end solutions from backend and database design to user interface preferred
• Basic experience working with secure file transfer protocols such as SFTP and FTPS

Competencies You’ll Bring to the Table:

• Strong problem solving skills with the ability to troubleshoot complex data and system issues
• Ability to manage multiple projects and integrations simultaneously in a fast paced environment
• Strong communication skills with the ability to engage both technical and non technical stakeholders
• Ability to lead requirements discussions and translate business needs into technical solutions
• Attention to detail and commitment to data accuracy and compliance
• Self directed with the ability to work independently while knowing when to collaborate
• Strong organizational and time management skills
• Collaborative mindset with cross functional team engagement
• Adaptability in dynamic environments with changing priorities
• Growth mindset with openness to feedback and continuous learning
• Ability to innovate and develop creative technical solutions
• Strong documentation and knowledge sharing practices

Work Environment:

This is a full-time, remote-first position with occasional on-site collaboration at OptiMed’s headquarters in Kalamazoo, Michigan. The role operates in a fast-paced environment where multiple projects and integrations are managed simultaneously.

The position requires prolonged computer use and the ability to work across multiple systems and tools daily. Occasional on-site presence may be required for collaboration, system setup, or project needs.

OptiMed Health Partners is an equal opportunity employer. Reasonable accommodations will be made for individuals with disabilities to perform essential job functions.

OptiMed Health Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Ready to Build Something That Matters?:

If you're excited about healthcare technology, enjoy the challenge of complex integrations, and want to join a team where your work has real impact, we'd love to hear from you.

Apply today and help us connect people to improved care.

OptiMed Health Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

• A computer science degree is preferred but not required. Equivalent work experience and demonstrated technical ability are valued.
• 1+ years of experience in a programming, ETL, or integrations role with examples of completed projects
• 1+ years of experience working with SQL (PostgreSQL strongly preferred), including writing queries, understanding schema design, and working with data
• 1+ years of experience working with Python in an ETL, automation, or scripting context preferred