The Payer EDI Pharmacy Subject Matter Expert (SME) serves as the authoritative resource on National Council for Prescription Drug Programs (NCPDP) standards within the payer Electronic Data Interchange (EDI) business product team. This role plays a critical part in shaping the future of healthcare data exchange by contributing to the development, implementation, and continuous improvement of Veterans Health Administration (VHA) Payer EDI pharmacy standards. The SME will participate in integrated project teams, collaborating with cross-functional stakeholders to ensure that pharmacy-related EDI solutions align with industry standards, regulatory requirements, and organizational objectives. Through their deep technical expertise and practical experience, the SME will guide project teams in interpreting and applying NCPDP standards to achieve seamless, compliant, and efficient data exchange.

• Serve as the primary subject matter expert on NCPDP standards within the payer EDI business product team.
• Provide strategic and technical guidance to project teams, ensuring accurate interpretation and application of NCPDP standards in healthcare data exchange initiatives.
• Actively participate in integrated project teams (IPTs), contributing expertise to the development and refinement of VHA Payer EDI pharmacy data exchange standards.
• Advise stakeholders on specific technical and functional issues related to pharmacy data transactions, including claims processing, eligibility, formulary, and real-time benefit check standards.
• Support the design and enhancement of EDI solutions by offering insights into evolving industry practices, compliance requirements, and implementation considerations.
• Collaborate with business analysts, developers, architects, and policy teams to ensure solutions are scalable, interoperable, and consistent with national standards.
• Monitor updates to NCPDP standards and proactively recommend improvements to internal processes, documentation, and training materials.

• Bachelor’s degree in healthcare administration, information technology, pharmacy, or a related field, or equivalent professional experience.
• Extensive experience (7+ years) in healthcare data exchange, payer systems, or pharmacy benefit management with a focus on EDI integration.
• Proven expertise in the National Council for Prescription Drug Programs (NCPDP) standards and their application in payer and pharmacy data exchange.
• Demonstrated ability to provide technical and functional guidance on pharmacy EDI standards in a cross-functional team environment.
• Strong understanding of healthcare interoperability, data governance, and regulatory compliance requirements.
• Excellent written and verbal communication skills with the ability to translate complex standards into actionable requirements.

• Master’s degree in health informatics, pharmacy, public health, or a related discipline.
• Experience working with the Veterans Health Administration (VHA) or other federal healthcare programs.
• Hands-on experience with standards development organizations (SDOs) or participation in standards-setting workgroups.
• Familiarity with other healthcare data exchange standards (e.g., HL7, FHIR, X12) and their integration with NCPDP transactions.
• Ability to lead workshops, training sessions, and technical reviews related to pharmacy EDI initiatives.

Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation. ​

We specialize in applying technology, creativity and human-centered services to optimize mission delivery and improve experiences for millions of people who count on government services every day. ​

Founded: 2012
Employees: 300+ nationwide

Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class.

Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.