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Pbm Analyst Jobs in Oregon (NOW HIRING)

OR ยท On-site

The center of gravity for this role is state-level PBM regulation, including licensing ... Strong analytical and problem-solving skills, with the judgment to balance legal risk, regulatory ...

OR ยท On-site

... PBM network participation rules, and HIPAA/HITECH. * Conduct targeted research, prepare summaries, and assist with regulatory analyses and alerts; coordinate with Compliance to ensure ownership and ...

... PBM network participation rules, and HIPAA/HITECH. * Conduct targeted research, prepare summaries, and assist with regulatory analyses and alerts; coordinate with Compliance to ensure ownership and ...

OR

$139K - $189K/yr

... PBM network participation rules, and HIPAA/HITECH. * Conduct targeted research, prepare summaries, and assist with regulatory analyses and alerts; coordinate with Compliance to ensure ownership and ...

Lead and manage PBM and ABM products, with full ownership of end-to-end product life cycle ... Strong analytical acumen, with the ability to translate complex data into actionable insights and ...

OR ยท On-site

$105K - $150K/yr

Enterprise PBM RFP Execution - Lead the writing and editing of complex RFP responses for enterprise ... Analyze RFP requirements and develop structured response outlines and timelines. * Write, edit, and ...

Overview The Epic Data Acquisition Analyst works with client health systems to extract clinical ... and PBA/PBM solutions-delivering excellence through tailored strategies and collaborative ...

Sr. Epic Data Acquisition Analyst

$85K - $108K/yr

Overview The Senior Epic Data Acquisition Analyst leads the Data Acquisition Team's engagements ... and PBA/PBM solutions-delivering excellence through tailored strategies and collaborative ...

Director, Trade Client Relations

OR ยท Remote

$155K - $175K/yr

... PBM), utilization management, pharmaceutical contracting, client relations, or analytical contracting * Must be eligible to work in the United States without need for work visa or residency ...

Sound analytical problem solving, decision making, memory retention, and organizational skills ... Externally with Moda members, PBM vendor, providers, provider offices, pharmacists, and pharmacies.

Are you detail-oriented, analytical, and interested in helping pharmacies strengthen compliance and ... PBM, and company requirements. * Review submitted and adjudicated claims to confirm that key claim ...

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Pbm Analyst information

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.
What cities in Oregon are hiring for Pbm Analyst jobs? Cities in Oregon with the most Pbm Analyst job openings:

Senior Attorney, Regulatory & Licensing

Prescryptive

OR โ€ข On-site

Full-time

Medical, Dental, Vision, Retirement

Posted 25 days ago


Job description

Who is Prescryptive?

Prescryptiveis the healthcare technology company enabling the direct access marketplace for prescription drugs. Our platform alignsincentivesso affordability, choice, and patient access become the natural outcome of a functioning system. Learn more about us by following us onLinkedInor visitingPrescryptive.com.

About this role

The Senior Attorney, Regulatory & Licensing will be a key member of Prescryptive's legal function, helping the company navigate the rapidly evolving state and federal regulatory environment affecting PBM operations, pharmacy, healthcare technology, digital prescribing, and drug pricing transparency. The center of gravity for this role is state-level PBM regulation, including licensing, registration, reporting, contracting, transparency, network access, and related operational requirements.

This role is both strategic and hands-on. You will advise the General Counsel, other legal team members, executive leaders, and cross-functional teams on state and federal legal and regulatory obligations; translate new and changing state requirements into practical business guidance; and help ensure Prescryptive can continue to innovate while meeting its compliance obligations.

The right candidate understands healthcare and is comfortable operating in a regulatory environment that is developing quickly. This person should be able to identify what has changed, assess what it means for Prescryptive, communicate the practical implications clearly, and partner with the business to implement compliant, workable solutions.

The ideal candidate brings strong PBM, pharmacy, healthcare technology, prescription drug, or healthcare regulatory experience; comfort working with state licensing and regulatory authorities; and the business judgment to support partnerships with manufacturers, health plans, pharmacies, technology vendors, and other healthcare stakeholders.

Principal Duties, Responsibilities

  • Monitor, track, interpret, and help operationalize emerging state PBM, pharmacy, and related healthcare laws and regulations, including licensing, registration, reporting, contracting, transparency, network access, and other operational requirements.
  • Advise internal stakeholders and senior management on federal and state healthcare regulations, including those related to PBM, pharma, pharmacy, and healthcare IT-related laws and regulations.
  • Support the review, negotiation and drafting of technology, healthcare, and pharmacy-related transactions, particularly where regulatory, licensing, reporting, or operational requirements need to be reflected in contract terms.
  • Partner with business leaders, IT, security, operations, and the Chief Compliance and Privacy Officer to ensure legal alignment with business objectives and operational execution, and new initiatives.
  • Interface with and respond to state and federal regulators, examiners, and other external parties.
  • Collaborate with other legal team members on standard template agreements and process improvements that increase quality, consistency, and speed across the legal function.

Required Skills

  • Strong understanding of state-level PBM, pharmacy, and related healthcare regulatory requirements, including licensing, registration, reporting, contracting, transparency, network access, and operational compliance obligations.
  • Ability to monitor, track, interpret, and operationalize emerging state and federal healthcare regulations, especially in PBM, pharmacy, prescription drug, healthcare technology, or payor environments.
  • Ability to work with and respond to state licensing authorities, regulators, examiners, and other external regulatory bodies.
  • Ability to translate complex and evolving legal requirements into practical business guidance for legal, compliance, operations, product, technology, and executive stakeholders.
  • Working knowledge of drug pricing transparency, rebates, formulary design, retail pharmacy network access, HIPAA, data privacy, security, and data sharing requirements.
  • Ability to support healthcare, pharmacy, PBM, healthcare technology, or payor-related contracts, including advising on regulatory, licensing, reporting, and operational requirements that should be reflected in applicable agreements.
  • Strong analytical and problem-solving skills, with the judgment to balance legal risk, regulatory expectations, business needs, and operational feasibility.
  • Excellent written and verbal communication skills, including the ability to provide clear, practical advice to legal and non-legal stakeholders.

Required Education and Experience:

  • Juris Doctor from an ABA-accredited law school.
  • Admission to practice, in good standing, as a member of at least one state bar or equivalent licensing authority.
  • Minimum 7 years of relevant legal experience; 10+ years preferred.
  • Significant experience in healthcare regulatory, PBM, pharmacy, healthcare technology, payor, prescription drug, or related highly regulated healthcare matters.
  • Prior in-house legal experience strongly preferred; comparable law firm experience advising healthcare, PBM, pharmacy, healthcare technology, payor, or prescription drug clients will be considered.

What we have to offer

  • The opportunity to help build the legal and regulatory foundation for an early-stage company shaking up a big, old-fashioned industry
  • Flexible time off, including 12 paid holidays
  • 401k match, plus 100% employer-paid medical, dental, and vision premiums
  • Company contribution to Health Savings Account
  • Stock options
  • Work location - remote, with occasional travel as business needs require

Prescryptive is committed to fair pay practices. The projected annual salary for this position is $195,000 to $245,000. When preparing an offer, we consider the candidate's experience, depth of healthcare and regulatory expertise, interview feedback, internal equity, and location.

Prescryptive is an Equal Opportunity Employer. Prescryptive does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.