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Techstra Solutions

PBM Business Analyst

Pittsburgh, PA · On-site +1

Role Overview The Business Analyst partners with business and technology stakeholders to modernize legacy PBM platforms, translate complex business needs into clear requirements, and support end-to ...

Marpai Administrators LLC

Reporting Analyst, PBM

Cary, NC · Remote

$65K - $85K/yr

The Reporting Analyst, PBM reports to the Account Executive, MarpaiRx and is responsible for developing, maintaining, and validating pharmacy claims reporting, operational dashboards, and client ...

Alivia Health

PR · On-site

Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses ...

Medone Pharmacy Benefit Solutions

PBM Underwriter

Analyze pharmacy claims data and develop reports for operations, sales and other key business units. * Support the financial aspects of PBM Request for Proposals (RFPs), and client market-checks to ...

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How much do pbm analyst jobs pay per year?

As of Jun 6, 2026, the average yearly pay for pbm analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

What are some common challenges PBM Analysts face when working with large healthcare data sets?

PBM Analysts often work with complex and highly sensitive healthcare data, which can pose challenges in terms of data integrity, accuracy, and privacy. Ensuring data is consistently clean and up to date requires strong attention to detail and proficiency with analytical tools. Additionally, analysts must regularly collaborate with cross-functional teams, such as clinical staff and IT, to reconcile data discrepancies and implement effective solutions, making communication skills essential for success.

What is the difference between Pbm Analyst vs Pbm Coordinator?

AspectPbm AnalystPbm Coordinator
CredentialsTypically requires a bachelor's degree in healthcare, pharmacy, or related field; certifications like CPC or CPhT are commonSimilar educational background; may also hold certifications but often less specialized
Work EnvironmentWorks in healthcare or pharmacy benefit management companies, analyzing data and optimizing formulariesSupports daily operations, manages provider and client communications within healthcare settings
Employer & Industry UsageUsed in pharmacy benefit management, health insurance, and healthcare organizationsCommon in healthcare administration, pharmacy services, and insurance companies

The Pbm Analyst and Pbm Coordinator roles share similar educational backgrounds and work environments within healthcare and pharmacy benefit management. However, Pbm Analysts focus more on data analysis and formulary optimization, while Pbm Coordinators handle operational support and client communications. Both roles are essential in healthcare organizations but differ in their primary responsibilities.

What is a PBM Analyst?

A PBM Analyst is a professional who works within the pharmacy benefit management (PBM) industry, focusing on analyzing data related to prescription drug benefits, costs, and utilization. Their role typically involves evaluating pharmacy claims, identifying trends, and generating reports to help optimize drug benefit plans for employers, insurers, or PBM companies. PBM Analysts play a critical role in controlling costs, ensuring compliance with regulations, and improving patient outcomes by providing actionable insights based on data. They often work with cross-functional teams, including pharmacists, IT specialists, and healthcare providers. Strong analytical skills and knowledge of healthcare data and pharmacy operations are essential for this role.

What are the key skills and qualifications needed to thrive as a PBM Analyst, and why are they important?

To thrive as a PBM Analyst, you need strong analytical skills, knowledge of pharmacy benefit management processes, and a background in healthcare or pharmacy, often supported by a relevant degree. Familiarity with data analysis tools like SQL, Excel, and pharmacy claims processing systems is typically required. Attention to detail, effective communication, and problem-solving abilities help you excel in collaborating with stakeholders and interpreting complex data. These skills ensure accurate analysis, compliance, and the optimization of pharmacy benefit programs for clients and members.
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Pbm Analyst jobs near you
PBM Business Analyst

PBM Business Analyst

Techstra Solutions

Pittsburgh, PA • On-site, Remote

Full-time

Posted 8 days ago

Job description

Role Overview
The Business Analyst partners with business and technology stakeholders to modernize legacy PBM platforms, translate complex business needs into clear requirements, and support end-to-end delivery across the SDLC. This role is key in defining future-state processes, data flows, and reporting solutions within a Java and cloud-based environment.
Key Responsibilities
  • Serve as a Subject Matter Expert (SME) in PBM Manufacturer Rebates andInvoicing processes, guiding system reviews, data flows, and future-state solution design
  • Collaborate with business and technology stakeholders to evolve Current State processes into a more robust and optimized Future State
  • Support the modernization of a legacy PBM platform into a Java / Cloud-basedapplication
  • Independently analyze business needs and produce high-quality project documentation and deliverables, including:
    • Business benefits and feasibility
    • Functional and technical requirements
    • Scope, risks, assumptions, and justification
  • Develop user stories and acceptance criteria in collaboration with the Product Owner
  • Assist with activities across the full Software Development Life Cycle (SDLC)
  • Document business and technical requirements (user stories, BRDs) supporting BI and reporting within the PBM rebates domain

Required Qualifications/Skills
  • Bachelor's degree in Computer Science, Information Technology, or related field
  • 5+ years of Business Analyst experience
  • 5+ years of experience working for a leading PBM processor, such as:
    • CVS Caremark (CVS Health)
    • Medco
    • Express Scripts (Cigna / Evernorth)
    • OptumRx (UnitedHealth Group)
    • Prime Therapeutics
    • SS&C
    • MedImpact
    • Humana
    • CarelonRx (formerly IngenioRx)
  • 3+ years of hands-on experience with PBM Manufacturer Rebates and Invoicing processes
  • Proven experience in systems and/or data analysis within PBM environments
  • Strong expertise in requirements gathering, documentation, and stakeholder management
  • PBM Manufacturer Rebates & Invoicing expertise
  • Business & Systems Analysis within PBM platforms
  • Requirements gathering (BRDs, user stories, acceptance criteria)
  • Stakeholder collaboration & SME advisory
  • Legacy system modernization (Java / Cloud)
  • Data analysis, BI & reporting support
  • SDLC delivery & Agile collaboration
Preferred Qualifications
  • Data analysis
  • SQL
  • writing user stories
Location: Remote
About Techstra Solutions
Techstra Solutions is a certified woman-owned (WBENC) management consulting firm specializing in strategy, technology, and implementation services for large organizations undergoing digital and talent transformation. Our experienced team partners with clients to co-create innovative solutions in applications, data, AI, and automation that accelerate measurable, sustainable change. From advisory consulting through technical execution, we are dedicated to driving world-class business solutions that fit your strategic requirements and deliver results. For more information: www.techstrasolutions.com
Equal Employment Opportunity Statement
Techstra Solutions is an equal opportunity employer. The Company makes its decisions on merit, and its policy of equal opportunity prohibits discrimination in all phases of the employment process, including, but not limited to, recruitment, hiring, promotion, selection, transfer, demotion, layoff, termination, compensation, benefits, and other terms and conditions of employment. The policy of equal opportunity applies without regard to race, color, creed, religion, gender, sexual orientation, gender identification, pregnancy, marital status, national origin, ancestry, age, disability that can reasonably be accommodated without undue hardship, military status, veteran status, genetic predisposition or carrier status, alienage or citizenship, domestic partnership status, arrest or conviction record, status as a victim of domestic violence, or any other protected categories under federal, state, or local law. The Company also prohibits discrimination or harassment based upon the perception that a person has, or is associated with a person who has, any of these characteristics.

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