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Pbm Compliance Jobs (NOW HIRING)

Prior pharmacy benefit management (PBM) or health insurance experience preferred. Competencies: * Proficient in Microsoft Office Professional. * Basic knowledge of regulatory and compliance ...

Responsible for leading complex pharmacy claim audits, ensuring compliance with client-specific ... S. degree 3-5 years experience Experience as a Pharmacy Tech and project managment within PBM ideal ...

Account Coordinator, PBM

Manhattan, NY · On-site

$69K - $86K/yr

Judi Health is looking for a results-driven Account Coordinator, PBM to support the PBM Commercial ... compliance. This position description is designed to be flexible, allowing management the ...

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Ensure compliance with CMS regulations, plan policies, and pharmacy benefit guidelines. * Document ... Experience with: * Pharmacy Benefit Management (PBM) * Prior Authorizations * Coverage ...

... compliance. Collaborating closely with cross-functional teams, you will contribute to enhancing ... Ability to assess and quantify risk factors associated with PBM contracts and pricing strategies.

PR · On-site

Monitor and interpret regulatory changes impacting PBM operations, including CMS guidelines, HIPAA, and Medicare Part D. * Assist in maintaining compliance with Medicare regulations, including ...

Account Coordinator, PBM

Denver, CO · On-site

$69K - $86K/yr

Judi Health is looking for a results-driven Account Coordinator, PBM to support the PBM Commercial ... compliance. This position description is designed to be flexible, allowing management the ...

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Pbm Compliance information

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$14

$24

$41

How much do pbm compliance jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for pbm compliance in the United States is $24.25, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $26.44 per hour, depending on experience, location, and employer.

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 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 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.

More about Pbm Compliance jobs

What cities are hiring for Pbm Compliance jobs?

Cities with the most Pbm Compliance job openings:

What states have the most Pbm Compliance jobs?

States with the most job openings for Pbm Compliance jobs include:

What job categories do people searching Pbm Compliance jobs look for?

The top searched job categories for Pbm Compliance jobs are:

Infographic showing various Pbm Compliance job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, and 4% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $50,446 per year, or $24.3 per hour.

Principal Architect - PBM Modernization & AI Engineering

Cigna

Austin, TX

Full-time

Posted 11 days ago


Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

41st of 893 rated healthcare providers


Job description

Principal Architect - PBM Modernization & AI Engineering

The Principal Architect - PBM Modernization & AI Engineering is a senior architecture leader responsible for designing and delivering modern technology solutions that accelerate the transformation of the Pharmacy Benefit Management (PBM) ecosystem.

As a key member of the PBM modernization program, this individual will partner closely with product, engineering, data, and business teams to modernize legacy platforms and enable scalable, cloud-native, API-first, and event-driven architectures. The Principal Architect will bring deep technical expertise developed through a progression from software engineering into architecture leadership and will serve as a trusted advisor on application architecture, engineering excellence, technology modernization, and AI adoption.

The successful candidate will possess extensive experience designing, building, and modernizing enterprise platforms utilizing modern technology stacks, including React, Java, Go, Node.js, cloud-native services, and modern data architectures. This role requires expertise across application architecture, data engineering, integration strategies, distributed systems, and software delivery practices, with the ability to guide engineering teams through complex transformation initiatives.

Artificial Intelligence will be a critical component of this role. The Principal Architect will help define and implement architectures that leverage Generative AI, Agentic AI, and intelligent automation to streamline business processes, improve operational efficiency, enhance customer experiences, and unlock new business capabilities. This leader will champion practical AI adoption across the software development lifecycle while ensuring solutions remain scalable, secure, compliant, and aligned with enterprise standards.

Key Responsibilities

Modernization, AI & Engineering Leadership

  • Lead the design and implementation of architecture solutions supporting strategic PBM modernization initiatives.

  • Drive the transformation of legacy applications into modular, cloud-native, API-first, and event-driven platforms.

  • Establish architecture standards, reference patterns, and engineering best practices that improve scalability, resiliency, maintainability, and speed to market.

  • Provide hands-on technical leadership through architecture reviews, solution design, proof-of-concept development, and critical engineering initiatives.

  • Partner with engineering teams to modernize application platforms using React, Java, Go, Node.js, Kubernetes, cloud-native services, and modern integration patterns.

  • Define and implement data architecture, data modeling, and data engineering strategies that support operational, analytical, and AI-driven business capabilities.

  • Drive adoption of DevSecOps, platform engineering, architecture automation, and AI-assisted software development practices.

  • Identify and implement opportunities to embed Generative AI, Agentic AI, and intelligent automation capabilities within PBM products and business workflows.

  • Define architectural patterns that support AI-enabled workflow automation, intelligent decision support, knowledge management, and operational excellence.

  • Leverage AI-powered engineering platforms and development copilots, including Claude Code, Cursor, GitHub Copilot, and emerging technologies, to accelerate modernization efforts, improve developer productivity, enhance software quality, and reduce delivery timelines.

  • Design and implement AI-enabled software engineering capabilities, including SDLC agents, reusable skills, prompt frameworks, and specification-driven development practices that automate architecture, coding, testing, documentation, and modernization workflows.

  • Ensure all solutions are secure, scalable, observable, compliant, and aligned with enterprise architecture principles and governance standards.

  • Mentor architects and engineers while fostering a culture of technical excellence, innovation, continuous learning, and modernization.

Preferred Qualifications

  • 8+ years of experience in software engineering, solution architecture, and technology leadership.

  • Demonstrated progression from hands-on software engineering roles into architecture leadership positions.

  • Deep expertise designing and building cloud-native applications utilizing Java, Go, Node.js, React, APIs, microservices, and event-driven architectures.

  • Strong background in data architecture, data modeling, data engineering, and modern data platforms.

  • Experience implementing Generative AI, Agentic AI, large language model (LLM)-based solutions, and intelligent automation capabilities in enterprise environments.

  • Experience within healthcare, pharmacy benefit management (PBM), payer, or pharmacy technology domains preferred.

  • Proven ability to influence senior technology and business leaders while driving large-scale modernization initiatives.

  • Strong communication, collaboration, and stakeholder management skills with the ability to translate complex technical concepts into business value.

  • Bachelor degree in Computer Science or related fields

Why This Role Matters

The Principal Architect serves as a key technical leader in the PBM modernization journey, translating strategic architecture vision into practical, scalable solutions. This role will help reduce technical debt, accelerate innovation, enable AI-driven transformation, and establish the technology foundation for the next generation of PBM platforms and digital capabilities. Through a combination of architectural leadership, engineering excellence, and AI innovation, this individual will play a critical role in shaping the future of the PBM technology landscape.

This version elevates the role to a more executive-level, strategic Principal Architect position while maintaining the hands-on modernization and AI engineering expectations.


If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.


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About Cigna

Sourced by ZipRecruiter

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Bloomfield, CT, US

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