PBM Specialist
Princeton, NJ ยท Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful ...
Quick apply
PBM Specialist
Princeton, NJ ยท Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful ...
PBM Specialist
Princeton, NJ ยท On-site +1
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful ...
PBM Specialist
Princeton, NJ ยท On-site +1
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful ...
PBM Underwriter
$83K - $124K/yr
Apply experiences with various PBM contract types (pass through and traditional) along with product ... Position Location This is a remote-based position within the Continental US. Responsibilities
PBM Underwriter
$83K - $124K/yr
Apply experiences with various PBM contract types (pass through and traditional) along with product ... Position Location This is a remote-based position within the Continental US. Responsibilities
PBM Underwriter
$83K - $124K/yr
Apply experiences with various PBM contract types (pass through and traditional) along with product ... Position Location This is a remote-based position within the Continental US. Responsibilities
PBM Underwriter
$83K - $124K/yr
Apply experiences with various PBM contract types (pass through and traditional) along with product ... Position Location This is a remote-based position within the Continental US. Responsibilities
Automated extraction of PBM contract terms and pricing components * AI-assisted summarization and comparison of bidder responses * Predictive modeling and benchmarking of PBM pricing outcomes
Automated extraction of PBM contract terms and pricing components * AI-assisted summarization and comparison of bidder responses * Predictive modeling and benchmarking of PBM pricing outcomes
Pharmacist (100% Remote)
$55/hr
Pharmacist (100% Remote, PBM) We are seeking a dedicated Clinical Pharmacist to join our team in a ... Experience in retail, managed care, or clinical pharmacy.๏ปฟ Job Type & Location This is a Contract ...
Pharmacist (100% Remote)
$55/hr
Pharmacist (100% Remote, PBM) We are seeking a dedicated Clinical Pharmacist to join our team in a ... Experience in retail, managed care, or clinical pharmacy.๏ปฟ Job Type & Location This is a Contract ...
Pharmacy Technician - PBM Services & Analytics
Austin, TX ยท Remote
$17 - $20.75/hr
Remote = Individuals in this position may work at an approved off-site location. They may be ... Conduct financial and data analyses to support formulary decisions, contract evaluations, and cost ...
Pharmacy Technician - PBM Services & Analytics
Austin, TX ยท Remote
$17 - $20.75/hr
Remote = Individuals in this position may work at an approved off-site location. They may be ... Conduct financial and data analyses to support formulary decisions, contract evaluations, and cost ...
Pharmacy Technician - PBM Services & Analytics
Austin, TX ยท Remote
$17 - $20.75/hr
Remote = Individuals in this position may work at an approved off-site location. They may be ... Conduct financial and data analyses to support formulary decisions, contract evaluations, and cost ...
Pharmacy Technician - PBM Services & Analytics
Austin, TX ยท Remote
$17 - $20.75/hr
Remote = Individuals in this position may work at an approved off-site location. They may be ... Conduct financial and data analyses to support formulary decisions, contract evaluations, and cost ...
Oversee and manage the full sales cycle-from lead generation and RFP response to contract ... Remote with travel to client locations, internal business meetings, and other locations as needed.
Oversee and manage the full sales cycle-from lead generation and RFP response to contract ... Remote with travel to client locations, internal business meetings, and other locations as needed.
Oversee and manage the full sales cycle-from lead generation and RFP response to contract ... Remote with travel to client locations, internal business meetings, and other locations as needed.
Oversee and manage the full sales cycle-from lead generation and RFP response to contract ... Remote with travel to client locations, internal business meetings, and other locations as needed.
Preferred Work Experience: * 3 years Experience in pharmacy reimbursement, PBM operations, payer ... Benefits & Incentives | WellSpan Careers (joinwellspan.org) #LI-REMOTE Duties and Responsibilities ...
Preferred Work Experience: * 3 years Experience in pharmacy reimbursement, PBM operations, payer ... Benefits & Incentives | WellSpan Careers (joinwellspan.org) #LI-REMOTE Duties and Responsibilities ...
Managing client contract renewal activities with the primary goals of retaining client, obtaining ... Proven solid PBM business and financial acumen * Proven excellent negotiation skills * Demonstrates ...
Managing client contract renewal activities with the primary goals of retaining client, obtaining ... Proven solid PBM business and financial acumen * Proven excellent negotiation skills * Demonstrates ...
We seek a Senior PBM Strategic Account Executive who is responsible for managing the overall ... Managing client contract renewal activities with the primary goals of retaining client, obtaining ...
We seek a Senior PBM Strategic Account Executive who is responsible for managing the overall ... Managing client contract renewal activities with the primary goals of retaining client, obtaining ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Ensures contract compliance, including negotiation and reporting of performance guarantees ... Profit & loss PBM client contract management experience * Experience messaging, positioning, and ...
Pharmacy Technician REMOTE
$20 - $23/hr
Respond to client inquiries regarding authorization approvals and the use of PBM online ... Job Type & Location This is a Contract to Hire position based out of Phoenix, AZ. Pay and Benefits ...
Pharmacy Technician REMOTE
$20 - $23/hr
Respond to client inquiries regarding authorization approvals and the use of PBM online ... Job Type & Location This is a Contract to Hire position based out of Phoenix, AZ. Pay and Benefits ...
Evaluates client contracts and amendments on an ongoing basis and tracks updated rebate payment ... Paid Time Off Work Environment / Physical Demands This position is in a typical remote office ...
Evaluates client contracts and amendments on an ongoing basis and tracks updated rebate payment ... Paid Time Off Work Environment / Physical Demands This position is in a typical remote office ...
Managing client contract renewal activities with the primary goals of retaining client, obtaining ... Proven solid PBM business and financial acumen * Demonstrates a high degree of client focus and ...
Managing client contract renewal activities with the primary goals of retaining client, obtaining ... Proven solid PBM business and financial acumen * Demonstrates a high degree of client focus and ...
Contract Remote Pbm information
What are some common challenges faced by professionals working as Contract Remote PBMs, and how can they be addressed?
One common challenge for Contract Remote PBM (Pharmacy Benefit Manager) professionals is maintaining clear communication with clients and team members, as remote work can sometimes lead to misunderstandings or delays. Additionally, staying updated on ever-changing pharmacy regulations and plan requirements can be demanding. To address these challenges, it's important to utilize reliable communication tools, establish regular check-in meetings, and actively participate in ongoing training. Building strong relationships with stakeholders and being proactive in addressing client concerns also contribute to successful remote contract management.
What is a Contract Remote PBM?
A Contract Remote PBM refers to a pharmacy benefit manager (PBM) who works on a contractual basis and operates remotely, rather than being employed full-time on-site. PBMs are companies or professionals that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers. Their primary responsibilities include negotiating with drug manufacturers and pharmacies to control drug spending, processing prescription drug claims, and creating formularies to determine which drugs are covered. A contract remote PBM performs these duties from a remote location, often utilizing digital tools to collaborate with clients and stakeholders.
What is the difference between Contract Remote Pbm vs Contract Remote Pharmacist?
| Aspect | Contract Remote Pbm | Contract Remote Pharmacist |
|---|---|---|
| Credentials | Licensing, certification in pharmacy benefit management | State pharmacy license, certification (e.g., PTCB) |
| Work Environment | Remote, healthcare/insurance industry | Remote, healthcare/pharmacy industry |
| Employer & Industry Usage | Health plans, PBMs, insurance companies | Pharmacy chains, hospitals, insurance companies |
| Common Search & Comparison | Yes | Yes |
Contract Remote Pbm roles focus on managing pharmacy benefits, requiring knowledge of benefit design and healthcare policies, while Contract Remote Pharmacist roles involve direct pharmacy practice, medication review, and dispensing. Both are remote healthcare positions but differ in responsibilities and industry focus.
What are the key skills and qualifications needed to thrive as a Contract Remote Pharmacy Benefit Manager (PBM), and why are they important?
To thrive as a Contract Remote PBM, you need a strong understanding of pharmacy benefit management, contract negotiation, and healthcare regulations, often supported by experience in pharmacy or healthcare administration. Familiarity with PBM software platforms, claims adjudication systems, and knowledge of regulatory compliance tools is essential. Excellent analytical skills, attention to detail, and effective remote communication are standout soft skills for this role. These abilities ensure optimal contract outcomes, regulatory adherence, and seamless collaboration with clients and stakeholders in a remote environment.
More about Contract Remote Pbm jobs
What cities are hiring for Contract Remote Pbm jobs? Cities with the most Contract Remote Pbm job openings:
What are the most commonly searched types of Remote Pbm jobs? The most popular types of Remote Pbm jobs are:
What states have the most Contract Remote Pbm jobs? States with the most job openings for Contract Remote Pbm jobs include:
What job categories do people searching Contract Remote Pbm jobs look for? The top searched job categories for Contract Remote Pbm jobs are:
Job description
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert โ
Remote work with some travel - 10%
US Citizens or Permanent Residents
JOB OVERVIEW
The PBA/PBM (SME) is responsible for supporting numerous aspects of the design, development and implementation (DDI) followed by maintenance and operations (M&O) of a new PBAmodule as part of Medicaid Enterprise System (MES) Modernization Program. This role provides support for all aspects of the PBA effort with the emphasis on ensuring all business requirements are met, all business processes are established and the new PBAmodule is successfully integrated with all components of State.
The PBA/PBM SME will work with various team members, stakeholders, vendors and the provider community to ensure successful delivery aligned with CMS and State requirements, funding rules, and State priorities. ย The role works closely with the current operations staff, the PBA Vendor, State Associate Director, Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful implementation of the new PBA Module. The PBA/PBM SME will operate under the direction of the State Associate Director during DDI and the Medicaid Manager during M&O.ย
Key RESPONSIBILITIES
Experience with PBA, PBR, FWA, and PCM.
โข Utilize strong Medicaid PBA processing knowledgeto support the Project Manager inguiding/driving the DDI.
โข Utilize vast historical PBA/PBM knowledge to lead discussions.
โข Provide PBA/PBM expertise on all aspects of the DDI and M&O efforts.
โข Review all PBA deliverables and ensure requirements are met in conjunction with the Project Manager.
โข Provide subject matter expertise in Pharmacy Benefit Administration orManagement(PBA/PBM), including cost avoidance strategies and pharmacy transparency dashboards, and collaborate with the DDI vendor to design and implement these capabilities.
โข Support cross-module planning to address data integration, shared services, and enterprise alignment.
โข Assist in facilitating cross team partnership to ensure interoperability and architectural consistency.
โข Support the testing efforts to ensure compliance.
โข Provide management recommendations throughout the project.
โข Identify issues and escalate as appropriate.ย ย
โข Ensure certification outcomes are clearly identifiedand addressed through all stages of the DDI.
โข Support CMS certification processes and reviews.
โข Support all OCM activitiesย ย
โข Support all internal stakeholder activities.
REQUIRED SKILLS AND EXPERIENCE
Qualifications
Required:
โข Bachelorโs degree in Business, Public Administration, a related field or comparable work experience.
โข Strong understanding of Medicaid programs and CMS oversight.
โข Minimum of six years of extensive PBA or PBMexperience.
โข Experience with engaging large stakeholder groups.
โข Excellent organization, analytic and communication skills.
Preferred:
โข Experience with State Medicaid modernization initiatives.
โข Experience with engaging with the Medicaid Provider Community.
โข Familiarity with CMS MITA framework and APD/CPR processes.
โข Familiarity with Gainwellโs MMIS system
Remote work with some travel - 10%
US Citizens or Permanent Residents
JOB OVERVIEW
The PBA/PBM (SME) is responsible for supporting numerous aspects of the design, development and implementation (DDI) followed by maintenance and operations (M&O) of a new PBAmodule as part of Medicaid Enterprise System (MES) Modernization Program. This role provides support for all aspects of the PBA effort with the emphasis on ensuring all business requirements are met, all business processes are established and the new PBAmodule is successfully integrated with all components of State.
The PBA/PBM SME will work with various team members, stakeholders, vendors and the provider community to ensure successful delivery aligned with CMS and State requirements, funding rules, and State priorities. ย The role works closely with the current operations staff, the PBA Vendor, State Associate Director, Pharmacy Manager, State Contract Lead and other team members supporting thesuccessful implementation of the new PBA Module. The PBA/PBM SME will operate under the direction of the State Associate Director during DDI and the Medicaid Manager during M&O.ย
Key RESPONSIBILITIES
Experience with PBA, PBR, FWA, and PCM.
โข Utilize strong Medicaid PBA processing knowledgeto support the Project Manager inguiding/driving the DDI.
โข Utilize vast historical PBA/PBM knowledge to lead discussions.
โข Provide PBA/PBM expertise on all aspects of the DDI and M&O efforts.
โข Review all PBA deliverables and ensure requirements are met in conjunction with the Project Manager.
โข Provide subject matter expertise in Pharmacy Benefit Administration orManagement(PBA/PBM), including cost avoidance strategies and pharmacy transparency dashboards, and collaborate with the DDI vendor to design and implement these capabilities.
โข Support cross-module planning to address data integration, shared services, and enterprise alignment.
โข Assist in facilitating cross team partnership to ensure interoperability and architectural consistency.
โข Support the testing efforts to ensure compliance.
โข Provide management recommendations throughout the project.
โข Identify issues and escalate as appropriate.ย ย
โข Ensure certification outcomes are clearly identifiedand addressed through all stages of the DDI.
โข Support CMS certification processes and reviews.
โข Support all OCM activitiesย ย
โข Support all internal stakeholder activities.
REQUIRED SKILLS AND EXPERIENCE
Qualifications
Required:
โข Bachelorโs degree in Business, Public Administration, a related field or comparable work experience.
โข Strong understanding of Medicaid programs and CMS oversight.
โข Minimum of six years of extensive PBA or PBMexperience.
โข Experience with engaging large stakeholder groups.
โข Excellent organization, analytic and communication skills.
Preferred:
โข Experience with State Medicaid modernization initiatives.
โข Experience with engaging with the Medicaid Provider Community.
โข Familiarity with CMS MITA framework and APD/CPR processes.
โข Familiarity with Gainwellโs MMIS system
About Associates Systems
Sourced by ZipRecruiter
Industry
Engineering professional services
Company size
1 - 10 Employees
Headquarters location
Dallas, TX, US
Year founded
2002