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AVTC Group

PBM Specialist

Princeton, NJ · On-site +1

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 ...

WellDyne

PBM Implementation Manager

PBM experience and/or project management work history. * Requires ongoing learning in the pharmacy benefit management industry and continuous product knowledge development in the areas of PBM ...

WELLDYNE

PBM Implementation Manager

PBM experience and/or project management work history. * Requires ongoing learning in the pharmacy benefit management industry and continuous product knowledge development in the areas of PBM ...

Vativo RX, LLC.

PBM Sales Executives

FL · Remote

PBM Sales Executive Job Summary The PBM Sales Executive (PBM) will be responsible for the sales within assigned markets, with specific responsibilities and dynamics varying by client/account. The PBM ...

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How much do pbm jobs pay per year?

As of Sep 5, 2026, the average yearly pay for pbm in the United States is $53,410.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,000.00 and $60,000.00 per year, depending on experience, location, and employer.

What is a PBM?

A PBM (Pharmacy Benefit Manager) job involves managing prescription drug benefits on behalf of health insurers, employers, and other payers. Responsibilities often include negotiating drug prices with manufacturers, creating formularies, processing pharmacy claims, and ensuring medication cost savings. PBM professionals work in roles such as clinical pharmacists, account managers, and analysts to optimize drug coverage and improve patient outcomes.

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

To thrive as a Pharmacy Benefit Manager (PBM), you need a solid understanding of pharmacy benefits, healthcare administration, insurance processes, and data analysis, often supported by a degree in pharmacy, healthcare management, or a related field. Familiarity with pharmacy claims processing systems, formulary management software, and compliance regulations is essential, and some roles may require pharmacy technician or pharmacist certification. Strong communication, negotiation, and organizational skills help PBMs collaborate with pharmacies, insurers, and clients while managing complex benefit structures. These capabilities are crucial for ensuring cost-effective, compliant, and efficient pharmacy benefit solutions for clients and patients.

What are some common challenges faced by Pharmacy Benefit Managers and how are they addressed?

Pharmacy Benefit Managers often encounter challenges such as staying compliant with frequently changing healthcare regulations, managing relationships between pharmacies, insurers, and clients, and controlling rising prescription drug costs. To address these challenges, PBMs work closely with cross-functional teams, leverage up-to-date technology platforms, and engage in ongoing education about regulatory requirements. Strong analytical skills help them assess and negotiate pricing strategies, while effective communication ensures all stakeholders are informed and aligned. By proactively managing these factors, PBMs play a key role in keeping healthcare affordable and accessible.

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Pbm jobs near you
Infographic showing various Pbm job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 93% Full Time, 2% Part Time, and 4% Contract. Highlights an 60% Physical, 7% Hybrid, and 33% Remote job distribution, with an average salary of $53,410 per year, or $25.7 per hour.

PBM Specialist

AVTC Group

Princeton, NJ • On-site, Remote

Full-time

Re-posted 15 days ago

Job description

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
Experience with PBA, PBR, FWA, and PCM.
•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

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