PBM Specialist
Princeton, NJ · Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... The role works closely with the current operations staff, the PBA Vendor, State Associate Director ...
Princeton, NJ · Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... The role works closely with the current operations staff, the PBA Vendor, State Associate Director ...
Princeton, NJ · Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... The role works closely with the current operations staff, the PBA Vendor, State Associate Director ...
Princeton, NJ · Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... The role works closely with the current operations staff, the PBA Vendor, State Associate Director ...
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Princeton, NJ · Remote
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert - Remote work with some ... The role works closely with the current operations staff, the PBA Vendor, State Associate Director ...
This role reports to and partners closely with the Director of PBM Performance, taking strategic direction while owning execution, process development, and advancement of the RFP function. The ideal ...
This role reports to and partners closely with the Director of PBM Performance, taking strategic direction while owning execution, process development, and advancement of the RFP function. The ideal ...
Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United ... Director of Underwriting How to Apply: If you're enthusiastic about helping others and eager to ...
Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United ... Director of Underwriting How to Apply: If you're enthusiastic about helping others and eager to ...
Miami, FL · Remote
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
Miami, FL · Remote
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
Required Qualifications: * 5 years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5 years of experience working with senior ...
Required Qualifications: * 5 years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5 years of experience working with senior ...
Wilmington, DE · On-site +1
$120K - $150K/yr
Description Customer Success Director Strategic Accounts | PBM Contract Advisory Wilmington, Delaware 19807 • Remote Role with Travel About Truveris Truveris is a pharmacy cost containment company ...
Wilmington, DE · On-site +1
$120K - $150K/yr
Description Customer Success Director Strategic Accounts | PBM Contract Advisory Wilmington, Delaware 19807 • Remote Role with Travel About Truveris Truveris is a pharmacy cost containment company ...
Dallas, TX · Remote
Account Executive - PBM (remote position) We wanted a PBM that worked better... so we created one ... Sense of Urgency Supervisory Responsibility This position does not have any direct supervisory ...
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Dallas, TX · Remote
Account Executive - PBM (remote position) We wanted a PBM that worked better... so we created one ... Sense of Urgency Supervisory Responsibility This position does not have any direct supervisory ...
Required Qualifications: * 5+ years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5+ years of experience working with senior ...
Required Qualifications: * 5+ years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5+ years of experience working with senior ...
Customer Success Director Strategic Accounts | PBM Contract Advisory Wilmington, Delaware 19807 • Remote Role with Travel About Truveris Truveris is a pharmacy cost containment company dedicated to ...
Quick apply
Customer Success Director Strategic Accounts | PBM Contract Advisory Wilmington, Delaware 19807 • Remote Role with Travel About Truveris Truveris is a pharmacy cost containment company dedicated to ...
Required Qualifications: * 5+ years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5+ years of experience working with senior ...
Required Qualifications: * 5+ years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5+ years of experience working with senior ...
Required Qualifications: * 5 years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5 years of experience working with senior ...
Required Qualifications: * 5 years of experience in strategic client relationship management within a PBM, or Health Plan with direct oversight of a PBM * 5 years of experience working with senior ...
Dallas, TX · Remote
Account Executive - PBM (remote position) We wanted a PBM that worked better... so we created one ... Sense of Urgency Supervisory Responsibility This position does not have any direct supervisory ...
Quick apply
Dallas, TX · Remote
Account Executive - PBM (remote position) We wanted a PBM that worked better... so we created one ... Sense of Urgency Supervisory Responsibility This position does not have any direct supervisory ...
Chicago, IL · Remote
$129K - $173K/yr
Direct development and execution of corrective action and remediation plans, addressing root causes ... State PBM regulatory requirements translated into system logic and operational workflows
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Chicago, IL · Remote
$129K - $173K/yr
Direct development and execution of corrective action and remediation plans, addressing root causes ... State PBM regulatory requirements translated into system logic and operational workflows
Dallas, TX · On-site +1
$90K - $125K/yr
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
Dallas, TX · On-site +1
$90K - $125K/yr
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
Miami, FL · Remote
$90K - $125K/yr
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
Miami, FL · Remote
$90K - $125K/yr
Remote or Dallas, TX * Important characteristics of ideal candidate: Detail-oriented, consultative ... Solid communication skills, ability to lead projects and influence others even without direct ...
This role requires deep knowledge of the PBM and healthcare benefits landscape, the SlateRx ... Remote with travel to client locations, internal business meetings, and other locations as needed.
This role requires deep knowledge of the PBM and healthcare benefits landscape, the SlateRx ... Remote with travel to client locations, internal business meetings, and other locations as needed.
This role requires deep knowledge of the PBM and healthcare benefits landscape, the SlateRx ... Remote with travel to client locations, internal business meetings, and other locations as needed.
This role requires deep knowledge of the PBM and healthcare benefits landscape, the SlateRx ... Remote with travel to client locations, internal business meetings, and other locations as needed.
$142K - $177K/yr
Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New ... The Director serves as the contracting authority for pharmacy provider agreements, leading ...
New
$142K - $177K/yr
Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New ... The Director serves as the contracting authority for pharmacy provider agreements, leading ...
New
Eden Prairie, MN · On-site +1
$91K - $163K/yr
As a key member of the account team, the Senior Account Manager supports the Senior Director of ... PBM Client Management experience working with HealthPlan clients * PBM reporting experience
Eden Prairie, MN · On-site +1
$91K - $163K/yr
As a key member of the account team, the Senior Account Manager supports the Senior Director of ... PBM Client Management experience working with HealthPlan clients * PBM reporting experience
$43K - $54.2K
7% of jobs
$54.2K - $65.4K
12% of jobs
$69.8K is the 25th percentile. Wages below this are outliers.
$65.4K - $76.5K
15% of jobs
The median wage is $86.4K / yr.
$76.5K - $87.7K
18% of jobs
$87.7K - $98.9K
14% of jobs
$106.8K is the 75th percentile. Wages above this are outliers.
$98.9K - $110.1K
13% of jobs
$110.1K - $121.3K
9% of jobs
$121.3K - $132.5K
4% of jobs
$132.5K - $143.6K
3% of jobs
$143.6K - $154.8K
3% of jobs
$154.8K - $166K
2% of jobs
$43K
$95.2K
$166K

Other
Posted 14 days ago
Pharmacy Benefit Administration/Management(PBA/PBM) Subject Matter Expert -
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. 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.
Key RESPONSIBILITIES
Utilize strong Medicaid PBA processing knowledgeto support the Project Manager inguiding/driving the DDI.
Utilize vast historical PBA/PBM knowledge to lead discussions.
Provide PBA/PBM expertise on all aspects of the DDI and M&O efforts.
Review all PBA deliverables and ensure requirements are met in conjunction with the Project Manager.
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.
Support cross-module planning to address data integration, shared services, and enterprise alignment.
Assist in facilitating cross team partnership to ensure interoperability and architectural consistency.
Support the testing efforts to ensure compliance.
Provide management recommendations throughout the project.
Identify issues and escalate as appropriate.
Ensure certification outcomes are clearly identifiedand addressed through all stages of the DDI.
Support CMS certification processes and reviews.
Support all OCM activities
Support all internal stakeholder activities.
REQUIRED SKILLS AND EXPERIENCE
Qualifications
Required:
Bachelor's degree in Business, Public Administration, a related field or comparable work experience.
Strong understanding of Medicaid programs and CMS oversight.
Minimum of six years of extensive PBA or PBMexperience.
Experience with engaging large stakeholder groups.
Excellent organization, analytic and communication skills.
Preferred:
Experience with State Medicaid modernization initiatives.
Experience with engaging with the Medicaid Provider Community.
Familiarity with CMS MITA framework and APD/CPR processes.
Familiarity with Gainwell's MMIS system
Sourced by ZipRecruiter
Engineering professional services
1 - 10 Employees
Dallas, TX, US
2002