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Medone Pharmacy Benefit Solutions

PBM Underwriter

Data mining, and financial modeling using industry standard tools in similar roles in Pharmacy Benefits Management (PBM), Retail Pharmacy, PBM Consulting, and/or Healthcare experience. * Ability to ...

OneDigital

PBM RFP & Pricing Lead - Remote

Work closely with audit, analytics, and consulting teams to align RFP outputs with downstream audit ... Deep understanding of PBM financial models, including: * AWP discounts, MAC pricing, and ingredient ...

Techstra Solutions

PBM Business Analyst

Pittsburgh, PA · On-site +1

Serve as a Subject Matter Expert (SME) in PBM Manufacturer Rebates and Invoicing processes ... From advisory consulting through technical execution, we are dedicated to driving world-class ...

Rx Valet, LLC

Be Seen First

PBM Operations Manager

Lawrenceville, GA · On-site

$65K - $85K/yr

Rx Valet is seeking an experienced, results-oriented PBM Operations Manager to lead our Shield PBM ... Pharmacy Consulting Firms * Benefits Administration Companies * Healthcare Service Organizations ...

Vativo RX, LLC.

PBM Sales Executives

FL · Remote

... consultative, and social capacity at appropriate trade shows, conferences, and industry events when it is necessary. · Prepare and maintain records for leads and performance toward goals, including ...

Rightway

Senior CSM, PBM

Miami, FL · Remote

This role requires a deep understanding of PBM services, strong communication skills, and the ... Detail-oriented, consultative and presentation skills, excellent communication & organization ...

allianthcm

Pharmacy Consultant

Alpharetta, GA · On-site

Reviews Pharmacy Benefit Manager (PBM) contracts and financial analysis of a proprietary Alliant ... consultant resources; Reviews pharmacy reports and identifies key trends with comparison to ...

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How much do pbm consultant jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for pbm consultant in the United States is $41.55, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $49.52 per hour, depending on experience, location, and employer.

What does a PBM Consultant do?

A PBM (Pharmacy Benefit Management) Consultant provides expertise on pharmacy benefits, helping organizations optimize drug plan costs, improve efficiency, and ensure compliance with regulations. They analyze pharmacy claims data, negotiate contracts with PBMs, and recommend strategies to enhance cost savings and patient outcomes. PBM Consultants often work with employers, health plans, or government agencies to design and oversee prescription drug benefit programs. Their role requires strong knowledge of healthcare policies, industry trends, and pharmacy benefit structures.

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

To excel as a PBM Consultant, you need a strong background in pharmacy benefit management, healthcare analytics, and benefit plan design, typically supported by a degree in pharmacy, healthcare administration, or a related field. Experience with PBM software platforms, claims processing systems, and knowledge of regulatory requirements such as HIPAA are crucial. Exceptional analytical thinking, effective communication, and the ability to build rapport with clients are highly valued soft skills. These competencies ensure consultants can effectively optimize drug benefit programs, maintain compliance, and deliver valuable solutions to clients.

What are some typical challenges a PBM Consultant faces in their day-to-day work?

PBM Consultants often navigate complex pharmaceutical benefit structures and must stay current with constantly changing drug formularies, regulations, and reimbursement models. They frequently analyze large volumes of claims data to identify cost-saving opportunities and address discrepancies, which requires strong attention to detail and technical expertise. Additionally, PBM Consultants may face the challenge of balancing competing interests among plan sponsors, members, and pharmacy networks while ensuring compliance. Working collaboratively with internal teams and external stakeholders is key to addressing these challenges and delivering effective, tailored solutions to clients.

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Pbm Consultant jobs near you
PBM Underwriter

PBM Underwriter

Medone Pharmacy Benefit Solutions

Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Job Type
Full-time
Description
Position Overview: As a PBM Underwriter, you will be a strategic team member that is key in both winning new and retaining existing business by compiling financial proposals that appeal to clients, while meeting MedOne goals.
About MedOne: MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.
What You'll Do:
  • Use proprietary Underwriting and Pricing Models, Excel, and SQL to model both prospective and existing client pharmacy spend, their underlying drivers of cost, as well as MedOne's profitability.
  • Analyze pharmacy claims data and develop reports for operations, sales and other key business units.
  • Support the financial aspects of PBM Request for Proposals (RFPs), and client market-checks to include coordinating PBM data requests, completing financial evaluation, and completing formulary and network evaluations
  • Assist with research, recommendations, and implementation of technology changes and reporting to improve accuracy of the Underwriting Model and optimize financial responses to PBM RFP procurement.
  • Complete formulary and network disruptions to aid in the onboarding process of new clients
  • Ability to work closely with Subject Matter Experts (such as Clinical, Proposal Services, and Rebates) teams to incorporate their most up to date guidance seamlessly into the Underwriting Model.
  • Collaborate with other departments in Strategic Pricing business unit on analyses and/or projects
  • Active participation and/or ownership in both quarterly and annual business unit priorities
  • Other duties as assigned

What You Will Bring to MedOne:
  • Bachelor's Degree in Math, Computer Science, Statistics or IT preferred
  • 1-3 years as a functional Data Analyst to include:
  1. Data mining, and financial modeling using industry standard tools in similar roles in Pharmacy Benefits Management (PBM), Retail Pharmacy, PBM Consulting, and/or Healthcare experience.
  2. Ability to translate business requirements to accurate technical specifications, with the end goal of creating optimized business reports that can be easily applied to meet the business use case
  3. System architecture and enterprise solution understanding.
  4. Intermediate knowledge of reporting, data analytics, and problem solving using analytical tools such as Excel, SAS, SQL, Power BI, and/or other ad hoc Query Tools
  5. Relevant experience that demonstrates problem-solving, financial acumen, and ability to understand, analyze and decrypt complex processes.
  • Ability to think strategically and proactively
  • Time management and prioritization skills.
  • Incredible work ethic and energy.

Why Join MedOne? At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth-all while helping to make a difference in people's lives. Our top core value is to prioritize your well-being . To support you in living this value, we offer:
  • Competitive salary and bonuses that reward your performance.
  • Comprehensive health, dental, and vision insurance + additional benefits
  • 401(k) with company match to secure your future.
  • Generous paid time off and holidays.
  • Opportunities for professional growth and development.
  • A vibrant and collaborative work culture.

Location: Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States.
Employment Type: Full Time, Salary/Exempt Position
Hours: Hours may vary within our normal business hours.
Reports to: Director of Underwriting
How to Apply: If you're enthusiastic about helping others and eager to join a dynamic team, we'd love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page .
MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Job Offers are contingent on passing a background check and drug screen.

Apply