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Pbm Business Analyst Jobs (NOW HIRING)

Agadia Systems Inc

Business Analyst

Parsippany, NJ · On-site

$60K - $100K/yr

Experience working with health plans, PBM, and specialty pharmacies is a plus. * Problem-solving and business analysis skills with strong attention to detail * Strong execution skills * Highly ...

AllSTEM Connections

IT Business Analyst

Indianapolis, IN · On-site

$140K - $145K/yr

Job Overview We are looking for a motivated IT Business Analyst / Healthcare Data Analyst with 1-3 ... Experience in Pharmacy, Healthcare, PBM, Health Insurance, Hospital, Pharma, or Biotech industries

MedImpact

Pricing & Business Analyst

Fremont, NE · On-site

$114K - $145K/yr

Stay updated on PBM industry trends, tools, and methodologies to enhance analytical capabilities ... Typical core business hours are Monday through Friday from 8:00am to 5:00pm. Travel This position ...

Forhyre

Business Analyst - Pharma

Charleston, WV

We are looking for a Claims Business Analyst who will be the vital link between our information ... Experience working within the Payer / PBM market (in particular Medicare and Medicaid, Part D and ...

Forhyre

Business Analyst - Pharma

Charlotte, NC

We are looking for a Claims Business Analyst who will be the vital link between our information ... Experience working within the Payer / PBM market (in particular Medicare and Medicaid, Part D and ...

Forhyre

OH

We are looking for a Claims Business Analyst who will be the vital link between our information ... Experience working within the Payer / PBM market (in particular Medicare and Medicaid, Part D and ...

Photon

Business Analyst | Onsite

Chicago, IL

... PBM or healthcare industry experience preferred). Computer Skills To perform this job successfully ... Certified Business Analysis Professional (preferred) Other Skills and Abilities Working knowledge ...

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How much do pbm business analyst jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for pbm business analyst in the United States is $47.43, according to ZipRecruiter salary data. Most workers in this role earn between $35.58 and $59.38 per hour, depending on experience, location, and employer.

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

To thrive as a PBM Business Analyst, you need strong analytical abilities, attention to detail, experience with pharmacy benefit management concepts, and typically a bachelor's degree in a related field. Familiarity with data analysis tools like SQL, Excel, and PBM platforms such as Medispan or RxCLAIM, plus certifications like Certified Pharmacy Technician (CPhT), are valuable assets. Effective communication, problem-solving skills, and the ability to collaborate with cross-functional teams set top candidates apart. These qualifications are vital for analyzing complex pharmacy data, ensuring accurate benefit administration, and driving improvements in healthcare delivery.

What are some common challenges faced by PBM Business Analysts, and how are they addressed in the workplace?

PBM Business Analysts often navigate large volumes of complex data and rapidly changing pharmacy benefit regulations, which can make ensuring data accuracy and compliance challenging. To address these challenges, analysts work closely with IT, clinical, and operations teams to validate processes, resolve data discrepancies, and stay updated on industry trends. Ongoing training and collaboration are key components of successful problem-solving in this role. Most companies also provide access to advanced analytical tools and experienced mentors to support continuous professional development and improve workflow efficiency.

What is a PBM Business Analyst job?

A PBM (Pharmacy Benefit Management) Business Analyst is responsible for analyzing data, systems, and processes within a PBM organization to improve efficiency and support business decisions. They work with claims processing, formularies, benefit designs, and pharmacy networks to ensure compliance and operational effectiveness. Their role includes gathering business requirements, identifying trends, and collaborating with stakeholders to optimize healthcare and cost management strategies. Proficiency in data analysis, healthcare regulations, and system implementation is essential for success in this role.

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Pbm Business Analyst jobs near you
Infographic showing various Pbm Business Analyst job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 6% Part Time, 1% Temporary, and 4% Contract. Highlights an 83% Physical, 7% Hybrid, and 10% Remote job distribution, with an average salary of $98,662 per year, or $47.4 per hour.

Business Analyst

Agadia Systems Inc

Parsippany, NJ • On-site

$60K - $100K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 7 days ago

Job description

About Agadia

We specialize in healthcare management technology and offer our clients a suite of utilization management software solutions. Our mission is dedicated to improving the quality of care and expediting the delivery of healthcare services by advancing and automating utilization management processes. We are based in Parsippany, NJ, with clients across the United States.

Job Overview

As we grow, we seek a detail-oriented, self-motivated, independent Business Analyst with strong domain expertise in FHIR (Fast Healthcare Interoperability Resources), Electronic Medical Records (EMR), and Healthcare Interoperability.

Job Responsibilities

Key Experience Areas:

  • FHIR Standards & API Integration:
    • Proven experience working with HL7 FHIR specifications, including resource modeling, API design, and implementation for clinical data exchange.
    • Lead requirements gathering and gap analysis for FHIR-based APIs to support patient data exchange across systems.
    • Collaborated with development teams to define resource mappings and ensure compliance with HL7 standards.
    • Participated in testing and validating FHIR endpoints for clinical and administrative data.
  • EMR Systems:
    • Hands-on experience with leading EMR platforms like Epic, Cerner, or Allscripts. Ability to analyze workflows, extract structured/unstructured data, and support integration efforts.
    • Worked with multiple EMR platforms (e.g., Epic, Cerner, Allscripts) to extract and normalize patient data for downstream processing.
    • Defined workflows for integrating EMR data into analytics platforms and care coordination tools.
    • Partnered with clinical stakeholders to ensure EMR configurations aligned with operational needs and regulatory requirements.
  • Healthcare Interoperability:
    • Deep understanding of interoperability frameworks, including CMS and ONC mandates, 21st Century Cures Act compliance, and payer-provider data exchange. Experience facilitating seamless data flow across systems using secure protocols and standardized formats.
    • Supported initiatives aligned with CMS and ONC interoperability mandates, including 21st Century Cures Act compliance.
    • Facilitated data exchange between payers, providers, and third-party applications using APIs and secure transport protocols.
    • Conducted impact assessments and documentation for interoperability enhancements, including patient access and provider directory services.
  • Business Analysis Skills:
    • Strong capabilities in requirements gathering, stakeholder engagement, process mapping, and documentation. Experience working in Agile environments and collaborating with cross-functional teams including developers, QA, and product owners.
Desired Skills
  • Strong verbal and written communication skills
  • Familiarity with utilization management processes, preferably prior authorization within all lines of business
  • Experience working with health plans, PBM, and specialty pharmacies is a plus.
  • Problem-solving and business analysis skills with strong attention to detail
  • Strong execution skills
  • Highly organized and flexible
  • Team Player
Qualifications
  • Three plus years working as a Business Analyst
  • Bachelor's Degree required.
  • Experience working with MS Office products.
  • Authorized to work in the USA without Sponsorship or Restrictions.

Please note: The Salary range is based on our market pay structure & includes benefits (Medical, Dental, Vision, life Insurance, 401 & PTO, etc.).

Key Competencies

Communicates effectively – Attentively listens to others, provides timely and helpful information, and is effective in various professional settings. Demonstrates excellent oral and written communication skills. Able to communicate effectively with all levels of the organization, from staff to senior leadership.

Being resilient - Demonstrates grace under pressure; maintains a positive attitude in adversity and rebounds from setbacks.

Manages complexity - Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. Has strong organizational skills and can manage multiple projects at once.
Ensures Accountability - Follows through on commitments and ensures others do the same. Able to work independently and as part of a team