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Pbm Analyst Jobs in Raleigh, NC (NOW HIRING)

Sedgwick

Vice President, Clinical Pharmacy

Raleigh, NC · On-site

$125K - $165K/yr

Provide analysis of claims data and book-of-business metrics, translating trends into actionable ... in PBM management and health care benefit knowledge. Active unrestricted license to practice ...

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All JobsPbm Analyst JobsPbm Analyst Jobs in Raleigh, NC

Pbm Analyst information

See Raleigh, NC salary details

$30.1K

$71.2K

$126.4K

How much do pbm analyst jobs pay per year?

As of Sep 1, 2026, the average yearly pay for pbm analyst in Raleigh, NC is $71,216.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $84,600.00 per year, depending on experience, location, and employer.

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 Raleigh, NC?

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

What job categories do people searching Pbm Analyst jobs in Raleigh, NC look for?

The top searched job categories for Pbm Analyst jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Pbm Analyst jobs?

Cities near Raleigh, NC with the most Pbm Analyst job openings:

Pbm Analyst jobs near you
Infographic showing various Pbm Analyst job openings in Raleigh, NC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 64% In-person, and 36% Remote job distribution, with an average salary of $71,216 per year, or $34.2 per hour.

Senior Strategic Advisor: Pharmacy

Blue Cross and Blue Shield of North Carolina

Durham, NC • On-site

$89K - $142K/yr

Other

Medical, Retirement, PTO

Re-posted 13 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

195th of 315 rated insurance

Job description

Job Description

Acts as a senior member of the strategic function by contributing to the achievement of innovation-based goals through new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportunities. Leverages industry experience and expertise to promote enterprise understanding of the key areas in which the company is seeking to create competitive differentiation and establish sustainable competitive advantage in the marketplace.

What You'll Do

  • Consult with ASO clients on pharmacy benefits, programs, and pricing.

  • Analyze client data to identify costsavings opportunities and utilization trends.

  • Conduct quarterly and annual utilization review meetings with clients.

  • Manage relationships with ASO clients, medical sales partners, and external consultants.

  • Proactively identify, evaluate, and support implementation of healthcare redesign, provider reimbursement, and partnership strategies that align with BCBSNC's growth objectives while managing costs and improving member outcomes and experience.

  • Support and manage development efforts related to the enhancement and maintenance of current products and market offer components.

  • Collaborate on and execute critical activities including strategic planning, complex financial and qualitative analysis, and thought leadership at departmental and enterprise levels.

  • Present strategic concepts, planning insights, medical expense and reimbursement data, provider performance metrics, and impact assessments to internal and external audiences, including seniorlevel leadership.

  • Organize, optimize, and communicate progress toward completion of the overall work portfolio.

  • Collaborate with crossfunctional partners across the enterprise on shared initiatives and unique ventures, serving as a subject matter expert in healthcare delivery transformation, reimbursement, and strategy.

  • Identify, analyze, and monitor industry, regulatory, technology, and market trends impacting divisional operations, provider reimbursement, medical expense strategy, and payerprovider dynamics.

  • Leverage expertise to drive operational improvements through enhanced analytics and reporting capabilities, project management techniques, and consulting or engagement approaches.

Hiring Requirements

  • Bachelor's degree or advanced degree (where required).

  • 5+ years of experience in a related field.

  • In lieu of a degree, 7+ years of relevant experience.

Great to Have

  • PBM or pharmacy experience.

  • Clientfacing sales or consultative experience.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$89,174.00 - $142,679.00

Skills

Healthcare Consulting, Healthcare Financial Management, Healthcare Industry, Healthcare Innovation, Healthcare Management, Healthcare Reimbursement, Healthcare Strategic Planning, Health Outcomes, Medical Reimbursement, Performance Metrics, Physician Reimbursement, Project Management, Provider Reimbursement, Reimbursement, Reporting and Analysis

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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