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Rxclaim Jobs (NOW HIRING)

Oscar Health

Pharmacy Program Associate

Tempe, AZ · Hybrid

$87K - $114K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Project Manager- Pharmacy Associate

Tempe, AZ · Hybrid

$87K - $114K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Project Manager- Pharmacy Associate

Tempe, AZ · On-site

$87K - $114K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Pharmacy Program Associate

New York, NY · On-site

$96K - $127K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Pharmacy Program Associate

New York, NY · Hybrid

$96K - $127K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Pharmacy Program Associate

Tempe, AZ · On-site

$87K - $114K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

Oscar Health

Pharmacy Program Associate

Dallas, TX · Hybrid

$87K - $114K/yr

Experience with medical payer and PBM claims adjudication systems, such as RxClaim. * Experience with pharmacy claim testing and Quality Assurance (QA). * Experience with a ticketing system (such as ...

UnitedHealthcare

Eligibility Business | , |

$23.89 - $42.69/hr

RxClaim working knowledge given * Experience with SQL OR other data analyzing tool * Ability to navigate and analyze large data files Telecommuting Requirements: * Ability to keep all company ...

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Rxclaim information

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$15K

$241.3K

$387K

How much do rxclaim jobs pay per year?

As of Jul 15, 2026, the average yearly pay for rxclaim in the United States is $241,295.00, according to ZipRecruiter salary data. Most workers in this role earn between $200,000.00 and $300,000.00 per year, depending on experience, location, and employer.

What are some common challenges faced by RxClaim Analysts or Specialists in their daily work?

RxClaim Analysts or Specialists often encounter challenges related to staying current with continually evolving healthcare regulations, benefits plan updates, and complex claims data. Troubleshooting claim adjudication issues—such as rejected or incorrectly processed claims—requires analytical skills and attention to detail. Additionally, working closely with IT teams, pharmacists, and insurance representatives to implement system changes or resolve urgent problems can be fast-paced and requires strong collaboration. Overcoming these challenges provides valuable experience and contributes to professional development in the healthcare technology sector.

What is an RxClaim job?

An RxClaim job typically involves working with the RxClaim system, which is a pharmacy claims processing platform used by pharmacy benefit managers (PBMs) and healthcare organizations. Responsibilities may include managing prescription claims, analyzing data, troubleshooting system issues, and ensuring compliance with healthcare regulations. Professionals in these roles often work in IT, customer support, or pharmacy operations to help maintain accurate and efficient prescription processing.

What are the key skills and qualifications needed to thrive in the Rxclaim position, and why are they important?

To thrive as an RxClaim Analyst or Specialist, candidates typically need strong experience in pharmacy benefits management, claims processing, and healthcare data analysis, often supported by a background in healthcare administration or an IT-related field. Proficiency with PBM platforms such as RxClaim software (from Change Healthcare), SQL, and other claims adjudication systems is highly valued, along with certifications in pharmacy technology or healthcare information systems. Attention to detail, problem-solving abilities, effective communication, and the ability to work collaboratively within cross-functional teams are key soft skills. These competencies ensure accurate claims processing, smooth system integration, and positive outcomes for both patients and healthcare providers.

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Rxclaim jobs near you
Director, AI ML Engineering - Remote

Director, AI ML Engineering - Remote

UnitedHealth Group

Schaumburg, IL • On-site, Remote

Full-time

Retirement

Re-posted 17 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 145 frontline employees who took The Breakroom Quiz

191st of 885 rated healthcare providers

Job description

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
  • Define and own the engineering AI strategy to measurably accelerate software development, quality, reliability, and operational efficiency through the use of AI agents
  • Partner with engineering teams to analyze current workflows, development activities, and pain points across the SDLC, identifying high-value opportunities where AI agents can deliver meaningful impact
  • Develop a clear, prioritized roadmap of AI agent use cases aligned to business objectives, engineering strategy, and enterprise technology standards
  • Build data-driven proposals and business cases for AI agent investments, including baseline measurements, expected productivity gains, cost avoidance, quality improvements, and adoption metrics
  • Lead the design, development, and deployment of AI agents that augment or automate engineering work (e.g., requirements analysis, design support, coding, testing, deployment, reliability, incident analysis)
  • Oversee the end-to-end lifecycle of AI agents from proof of value through scaled production deployment, ensuring solutions are reliable, secure, observable, and maintainable
  • Establish measurement frameworks, analytics, and KPIs to track realized value and continuously refine AI solutions based on usage, outcomes, and feedback
  • Define a repeatable operating model for how engineering teams identify, build, govern, and adopt AI agents at scale
  • Ensure all AI solutions adhere to enterprise architecture, security, privacy, regulatory, and responsible AI standards, including appropriate human-in-the-loop controls
  • Drive engineering enablement and change management, helping teams adopt new AI-enabled ways of working and build confidence using AI as a force multiplier
  • Serve as a trusted advisor and thought leader to engineering and technology leadership, translating complex AI concepts into clear decisions, trade-offs, and business outcomes
  • Collaborate closely with architecture, platform, product, data, and security partners to align AI agent strategy with broader enterprise initiatives

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Bachelor's degree or equivalent practical experience in applied AI, technology strategy, or complex enterprise systems
  • 10+ years of experience delivering and leading complex technology initiatives, with demonstrated expertise either through hands-on software engineering experience OR through deep technical partnership roles, including the driving or ownership of complex systems, platforms, or large-scale transformation initiatives
  • Experience connecting AI initiatives to measurable business value, using data, analytics, and outcome-based metrics
  • Demonstrated experience designing, building, or operationalizing AI-powered solutions, including agent-based or LLM-driven systems applied in real-world environments
  • Deep understanding of modern AI techniques and platforms, including large language models and agent frameworks used to accelerate software development and analysis
  • Proven ability to identify high-value AI opportunities, translate them into clear use cases, and support delivery through collaboration with engineering teams

Preferred Qualifications:
  • Experience in PBM, U.S. Healthcare and/or RxClaim platform
  • Experience designing, building, or leading agentic AI or multi-agent systems deployed in production environments
  • Familiarity with modern SDLC and DevOps practices and how AI can accelerate areas such as testing, code quality, deployment, operations, and reliability
  • Background in platform, enablement, or productivity teams, driving adoption of shared capabilities at scale
  • Demonstrated success leading organizational change, moving teams from experimentation to sustained, value-driven technology adoption
  • Proven excellent communication and leadership skills, with the ability to operate credibly across engineering, product, and executive stakeholders

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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