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Pbm Compliance Jobs in Boca Raton, FL (NOW HIRING)

BrightSpring Health Services

Pharmacist

Hollywood, FL

$53.25 - $64/hr

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

BrightSpring

Pharmacist

Hollywood, FL

$53.25 - $64/hr

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

BrightSpring Health Services

Pharmacist

Hollywood, FL · On-site

$53.25 - $64/hr

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

OnePoint Patient Care

Pharmacist

Hollywood, FL · On-site

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

OnePoint Patient Care

Pharmacist

Hollywood, FL · On-site

$53.25 - $64/hr

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

BrightSpring Health Services

Pharmacist

Pembroke Pines, FL · On-site

$53.25 - $64/hr

Ensure compliance with all state and federal regulatory requirements related to pharmacy practice ... Through its Concierge PBM, Next Day Valet mail order, and Direct Express local services, OnePoint ...

ChenMed

Ambulatory Pharmacist

Lauderhill, FL · On-site

$118K - $168K/yr

... compliance. * Lab Testing & Monitoring: Orders, interprets, and utilizes laboratory results to ... Experience in managed care, HMO, PBM, or MSO settings is a plus PAY RANGE: $118,062 - $168,658 ...

ChenMed, LLC

Ambulatory Pharmacist

Lauderhill, FL · On-site

$118K - $168K/yr

... compliance. * Lab Testing & Monitoring: Orders, interprets, and utilizes laboratory results to ... Experience in managed care, HMO, PBM, or MSO settings is a plus PAY RANGE: $118,062 - $168,658 ...

All JobsPbm Compliance JobsPbm Compliance Jobs in Boca Raton, FL

Pbm Compliance information

See Boca Raton, FL salary details

$13

$23

$39

How much do pbm compliance jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for pbm compliance in Boca Raton, FL is $23.01, according to ZipRecruiter salary data. Most workers in this role earn between $17.36 and $25.10 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a PBM Compliance professional?

To thrive as a PBM Compliance professional, you need a strong understanding of pharmacy benefit management regulations, healthcare laws, and compliance protocols, often supported by a degree in healthcare, pharmacy, or a related field. Familiarity with regulatory research tools, compliance management systems, and auditing software is typically required, along with certifications such as Certified Compliance & Ethics Professional (CCEP) being advantageous. Attention to detail, ethical judgment, and strong communication skills help professionals navigate complex regulations and collaborate with cross-functional teams. These skills and qualifications are crucial to ensure adherence to legal requirements, minimize risk, and maintain the integrity of PBM operations.

What is PBM compliance?

PBM compliance refers to the adherence to regulations, laws, and contractual requirements governing Pharmacy Benefit Managers (PBMs). PBM compliance professionals ensure that PBMs operate within federal and state guidelines, particularly regarding drug pricing, patient privacy (such as HIPAA), and contracts with pharmacies and drug manufacturers. Their work helps prevent fraud, waste, and abuse in the prescription drug supply chain, protecting both patients and health plan sponsors. Compliance in this field is critical to maintaining transparency, ethical practices, and trust within the healthcare system.

What are some common challenges faced in a PBM Compliance role, and how can I prepare to address them?

Professionals in PBM (Pharmacy Benefit Manager) Compliance often navigate complex regulatory requirements and frequent changes in healthcare laws. Common challenges include staying updated with evolving state and federal regulations, ensuring internal processes remain compliant, and effectively communicating compliance expectations across departments. To prepare, candidates should develop strong attention to detail, keep current with industry updates, and build collaborative relationships with legal, clinical, and operational teams. Proactive learning and ongoing professional development are essential for success in this dynamic environment.

What is the difference between Pbm Compliance vs Pharmacy Technician?

AspectPbm CompliancePharmacy Technician
Required CertificationsOften requires PBM-specific certifications, compliance trainingCertified Pharmacy Technician (CPhT) typically required
Work EnvironmentFocus on PBM operations, regulatory compliance, auditsWork in retail, hospital, or mail-order pharmacies assisting pharmacists
Industry UsagePrimarily in pharmacy benefit management companiesIn various pharmacy settings across healthcare

While both roles are involved in pharmacy operations, Pbm Compliance specialists focus on regulatory adherence within PBMs, whereas Pharmacy Technicians assist pharmacists in daily pharmacy tasks. Understanding these differences helps clarify career paths and employer expectations in the pharmacy industry.

What are popular job titles related to Pbm Compliance jobs in Boca Raton, FL?

For Pbm Compliance jobs in Boca Raton, FL, the most frequently searched job titles are:

What job categories do people searching Pbm Compliance jobs in Boca Raton, FL look for?

The top searched job categories for Pbm Compliance jobs in Boca Raton, FL are:

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Cities near Boca Raton, FL with the most Pbm Compliance job openings:

Pbm Compliance jobs near you

Pharmacy Credentialing Specialist

LTC PHARMA HLDG LLC

Fort Lauderdale, FL • On-site

Full-time

Posted yesterday

New

Job description

WHO WE ARE
At Polaris Pharmacy Services, we're more than a pharmacy - we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job - we provide competitive pay, robust benefits, and genuine opportunities for career advancement.
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.
Job Summary:
The Pharmacy Credentialing Specialist is responsible for managing the credentialing, enrollment, and network participation processes for the pharmacies. This role ensures accurate and timely completion of payer applications, pharmacy enrollment requirements, contract documentation, and database maintenance across all lines of business, including PBM/Payer, PSAO, NCPCP, Medicare, and Medicaid. The Specialist serves as the primary point of contact for payer network participation matters and maintains organized, up-to-date records of all contractual agreements.
Duties/Responsibilities:
Credentialing & Enrollment:
  • Complete, submit, and track credentialing and re-credentialing applications for PBMs, payers, PSAOs, Medicare, and Medicaid programs.
  • Ensure all enrollment applications are accurate, complete, and submitted within required timeframes to avoid lapses in network participation and additional fees.
  • Monitor application status and follow up proactively with payers, PSAOs, and government programs to resolve delays or missing information.
  • Maintain awareness of enrollment deadlines, revalidation cycles, and renewal requirements for all applicable programs.

Contract & Documentation Management:
  • Maintain complete, organized copies of all executed contracts and agreements (PBM/Payer, PSAO, Medicare, Medicaid) in a shared drive, ensuring version control and easy retrieval.
  • Review contract terms, effective dates, and amendments to ensure compliance with enrollment and credentialing obligations.
  • Track contract expiration and renewal dates, flagging upcoming actions needed to maintain continuous network participation.

Database & Records Maintenance:
  • Maintain accurate, current records of credentialing status, provider/pharmacy demographic information, and enrollment data in internal systems and payer portals.
  • Ensure consistency of pharmacy information (NPI, NCPDP, DEA, licensure, ownership, etc.) across all payer and regulatory databases.
  • Conduct regular audits of credentialing files and databases to identify and correct discrepancies.

Payer Communication & Change Notifications:
  • Prepare and submit timely pharmacy change notifications to payers, PBMs, and PSAOs (e.g., ownership changes, address changes, NPI updates, licensure updates, pharmacist-in-charge changes).
  • Serve as liaison between the pharmacy and payer/PSAO representatives regarding credentialing, enrollment, and network status inquiries.
  • Communicate credentialing or enrollment issues to internal stakeholders and leadership in a timely manner.

Compliance & Quality
  • Ensure all credentialing and enrollment activities comply with applicable federal, state, and payer-specific regulations and requirements.
  • Stay current on changes to Medicare, Medicaid, and PBM/PSAO credentialing requirements and communicate relevant updates internally.
  • Support internal and external audits by providing documentation related to credentialing and contract status.

QUALIFICATIONS/COMPETENCIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
  • High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
  • Experience in pharmacy operations, healthcare credentialing, payer enrollment, or a related administrative role.
  • Familiarity with PBM, PSAO, Medicare, and Medicaid enrollment and credentialing processes.
  • Strong organizational skills with high attention to detail and accuracy.
  • Proficiency with Microsoft Office (Excel, Word, Outlook) and shared drive/document management systems.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple deadlines and prioritize competing tasks independently.

Preferred:
  • Experience with pharmacy credentialing platforms or payer portals (e.g., NCPDP, PECOS, CAQH, state Medicaid portals).
  • Knowledge of pharmacy licensing, NPI/NCPDP/DEA registration processes.
  • Prior experience in a multi-site pharmacy, PSAO, or pharmacy services administration environment.

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