ZipRecruiter

Log In

1

Pbm Analyst Jobs in Kentucky (NOW HIRING)

BrightSpring

3rd Party Plan Analyst

Louisville, KY

The 3rd Party Analyst is responsible for configuring 3rd party insurance setups within our ... PBM's), pharmacy claim switches, and other vendors regarding claim or plan inquiries * Understand ...

Elevance Health

Business Consultant

Louisville, KY · On-site

$87K - $131K/yr

Knowledge of PBM operations, pharmacy claims adjudication, and benefit configuration is preferred * Experience with impact analysis, operational risk assessments, and root cause investigations is ...

Fresche Solutions Inc

$100 - $125/hr

You will help analyze requirements, develop solutions, resolve production issues, and ensure ... Experience with RxClaim or other PBM adjudication systems * Experience leading technical tasks ...

New

ISHE

$80 - $100/hr

The Senior Analyst, FP&A - Network Consolidation & Management Process supports the end-to-end ... Financial planning, P&L consolidation, and reporting skills in a PBM, managed care, or health ...

Colorado Psychiatric

$80 - $100/hr

The Sr. Analyst also owns calendar management and process coordination for close, budget, and ... Financial planning, P&L consolidation, and reporting skills in a PBM, managed care, or health ...

NHSHP

$80 - $100/hr

The Senior Analyst, FP&A - Network Consolidation & Management Process supports the end-to-end ... Financial planning, P&L consolidation, and reporting skills in a PBM, managed care, or health ...

Elevance Health

Business Consultant

Louisville, KY · On-site

$87K - $131K/yr

Knowledge of PBM operations, pharmacy claims adjudication, and benefit configuration is preferred * Experience with impact analysis, operational risk assessments, and root cause investigations is ...

Luminare Health

$150 - $200/hr

... PBM, or analytics/data platforms) with deep understanding of industry data models and business drivers * Advanced technical proficiency in SQL Server (complex query design), Microsoft Excel, and BI ...

Posted today

LucyRx

$60 - $80/hr

While we're new to the PBM space, LucyRx is built on decades of leadership experience and a ... Analytical and detail-oriented thinking * Clear, professional communication * Adaptability across ...

Prescryptive Health, Inc.

$200 - $250/hr

Analyze client and product profitability and bring forward insights on network economics ... Deep understanding of PBM economics, including pharmacy network pricing, specialty utilization ...

Valid8 Financial, Inc.

$125 - $150/hr

Data Analysis, Reporting, and Performance Management • Analyze pharmacy claims, utilization ... S. jurisdiction. • Two to five years of experience in a client-facing managed care, PBM, health ...

Gainwell Technologies

$60 - $80/hr

Senior Business Analyst - Preferred Drug List (PDL) Date: Sep 2, 2026 Location: Any city, IL, US ... Pharmacy Experience as a Pharmacy Technician or working for a PBM * Knowledge of drugs and drug ...

New

Bristol-Myers Squibb

$200 - $250/hr

Continuously monitor the evolving PBM, GPO and managed care landscape, analyzing market trends, competitor activities, and policy changes that could impact market access. * Performance monitoring:

Gainwell Technologies

$150 - $200/hr

Senior Manager, Healthcare Data Integration and Analytics Date: Aug 21, 2026 Location: Any city ... Oversee integration workstreams across large-scale Medicaid, MMIS, PBM, payer, and healthcare ...

RXinsider LTD.

$100 - $125/hr

Oversee a portfolio of assigned Health Plan and PBM clients, building and maintaining strong ... Analyze customer performance metrics, provide business insights, and develop recommendations that ...

New

Gainwell Technologies

$125 - $150/hr

Summary The Provider Contract Lead will support Gainwell's work as the S PBM f or Ohio by helping ... Experience with operational reporting, KPIs, audits, process improvement, data analysis, and Excel

Surescripts

$100 - $125/hr

Oversee a portfolio of assigned Health Plan and PBM clients, building and maintaining strong ... Analyze customer performance metrics, provide business insights, and develop recommendations that ...

RXinsider LTD.

$100 - $125/hr

... analysis, and an orientation toward clear, audience-appropriate communication. Experience in pharma, pharma consulting, at a health insurer, or at a PBM is required: this work depends on ...

New

previous pagenext page

Showing results 21-40

All JobsPbm Analyst JobsPbm Analyst Jobs in Kentucky

Pbm Analyst information

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.

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 are popular job titles related to Pbm Analyst jobs in Kentucky?

For Pbm Analyst jobs in Kentucky, the most frequently searched job titles are:

What job categories do people searching Pbm Analyst jobs in Kentucky look for?

The top searched job categories for Pbm Analyst jobs in Kentucky are:

What cities in Kentucky are hiring for Pbm Analyst jobs?

Cities in Kentucky with the most Pbm Analyst job openings:

Pbm Analyst jobs near you
Infographic showing various Pbm Analyst job openings in Kentucky as of August 2026, with employment types broken down into 100% Full Time. Highlights an 65% In-person, and 35% Remote job distribution.

3rd Party Plan Analyst

BrightSpring

Louisville, KY

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 11 days ago

BrightSpring Health Services rating

4.9

Company rating: 4.9 out of 10

Based on 65 frontline employees who took The Breakroom Quiz

224th of 247 rated social care providers

Job description

Our Company
PharMerica
Overview
PharMerica, a part of Brightspring Health Services, is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.
As a a non-retail pharmacy, we focus on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation facilities, long-term acute care centers, and other specialized care centers nationwide. Our organization is in high growth mode, which can provide opportunities for advancement for individuals looking for career progression!
The 3rd Party Analyst is responsible for configuring 3rd party insurance setups within our proprietary system, and monitoring and evaluating events related to 3rd party claims. The 3rd party analyst will interact with appropriate departments to ensure integrity of third party claim information and provide pharmacy operations support. The position specializes in pharmacy claim billing and reimbursement detail. Analyst are considered experts in Medicare Part D, Medicaid, and Commercial insurance. The analyst will also assist with special projects and ad hoc assignments as needed.
Requirements
  • Two or more years of experience as a Pharmacy Technician or in a billing position within a Health Care setting
  • Required: One or more years of experience with Pharmacy or Health Data analysis and working in a Pharmacy, long-term or managed care setting
Schedule: Monday - Friday, 8:00am - 4:30pm
Our Benefits Include:
  • Competitive pay
  • Health, dental, & vision
  • Company paid STD & LTD
  • Paid Time Off
  • Flexible Schedules
  • Tuition Reimbursement
  • 401k
  • Employee Discount Program
  • Daily Pay
  • Pet Insurance

Responsibilities
  • Communicate effectively and professionally with 3rd party entities including Pharmacy Benefit Managers (PBM's), pharmacy claim switches, and other vendors regarding claim or plan inquiries
  • Understand various payer requirements and configure billing parameters within proprietary software to send online transactions to and from 3rd party insurance payers in accordance with HIPAA named standards set forth by the National Council for Prescription Drug Programs (NCPDP)
  • Review 3rd party payer sheets for specific configuration details
  • Construct telecom standard field specific templates for each payer
  • Communicate with switching company to construct external pre and post claim edits to prevent claim denials and ensure proper reimbursement
  • Send and receive contracts on behalf of the Director of 3rd Party Network Services
  • Work with Compliance team to obtain, reissue, or renew Medicaid provider ID's, and work with other internal teams across the organization
  • Serve as subject matter expert (SME) on cross functional work groups
  • Provide operational support and troubleshooting to resolve both internal and external inquiries
  • Research and resolve complex billing issues with available resources and tools
    • This includes researching both denied and paid claim transactions, understanding root cause for denied claims or under reimbursement on paid claims, implementing methods to reduce such claims, or educating pharmacies on prevention opportunities
  • Ensure all industry and/or payer related changes are communicated throughout the organization
  • Independently and accurately manage workload in a timely manner with minimal direction
  • Communicate when competing priorities cannot be managed independently
  • Prepare recurring reports related to claim denials or payments
  • Query, massage, and analyze small to medium sums of claim data
  • Summarize and report findings to executive management or other internal teams
  • Support project teams in the development of functional requirements
  • Performs other tasks as assigned
  • Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Qualifications
Education/Learning Experience:
  • Required: HS Diploma, GED, or equivalent experience
  • Desired: Associate or Bachelor's degree
Licenses/Certifications:
  • Desired: Pharmacy Technician
Work Experience:
  • Required: Two or more years of experience as a Pharmacy Technician or in a billing position within a Health Care setting
  • Required: One or more years of experience with Pharmacy or Health Data analysis and working in a Pharmacy, long-term or managed care setting
Skills/Knowledge:
  • Required: Excellent verbal and written communication skills; Excellent time management skills; ability to work independently and manage multiple/competing priorities; Proven ability to work with a high degree of accuracy and attention to detail; Proficient in all Microsoft Word and Outlook; Demonstrated analytical skills, technical knowledge and creative problem solving techniques; Ability to effectively navigate ambiguous situations with limited direction; Advanced analytical skills with the ability to interpret and synthesize complex data sets; Able to handle high volume and significant workload
  • Desired: Query building experience through use of Microsoft Access or other proprietary system; familiarity with long term care pharmacy or facility billing practices

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

What BrightSpring Health Services employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom