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Pbm Contracting Jobs in California (NOW HIRING)

Palliative Admissions RN

Torrance, CA · On-site

$53.25 - $82.68/hr

... is contracted with St. Joseph Hospice Services in order to assure appropriate financial ... PBM informed of admissions and faxes them the necessary documents for entry into their systems. • ...

Ascertains if insurance is contracted with St. Joseph Hospice Services in order to assure ... Keeps Pharmacy and PBM informed of admissions and faxes them the necessary documents for entry into ...

Palliative Admissions RN

Torrance, CA · On-site

$53.25 - $82.68/hr

... is contracted with St. Joseph Hospice Services in order to assure appropriate financial ... PBM informed of admissions and faxes them the necessary documents for entry into their systems. • ...

Showing results 41-45

Pbm Contracting information

What is the difference between Pbm Contracting vs Pbm Electrician?

AspectPbm ContractingPbm Electrician
CredentialsGeneral contracting license, safety certificationsElectrical license, journeyman or master electrician certification
Work EnvironmentConstruction sites, project managementElectrical installations, maintenance, troubleshooting
Employer & IndustryConstruction companies, general contracting firmsElectrical contractors, industrial and commercial facilities

While Pbm Contracting oversees entire construction projects, Pbm Electrician specializes in electrical systems installation and repair. Both roles require safety certifications, but Pbm Electrician focuses specifically on electrical work, often within the broader scope of Pbm Contracting projects.

What is PBM contracting?

PBM contracting refers to the agreements made between Pharmacy Benefit Managers (PBMs) and other entities, such as pharmacies, drug manufacturers, or health plans. These contracts determine how prescription drug benefits are managed, including drug pricing, reimbursement rates, formulary management, and rebate arrangements. PBM contracting plays a crucial role in controlling drug costs and ensuring access to medications for patients. Understanding these contracts is important for healthcare providers, pharmacies, and insurers to optimize drug benefit management and costs.

What are some common challenges faced by professionals working in PBM contracting, and how can they be addressed?

Professionals in PBM (Pharmacy Benefit Management) Contracting often encounter challenges such as navigating complex negotiations with pharmaceutical manufacturers and health plan clients, staying current with evolving regulations, and balancing cost containment with maintaining access to quality medications. Success in this role requires strong analytical and communication skills, as well as a collaborative approach to working with legal, clinical, and sales teams. Staying proactive in monitoring industry trends and participating in ongoing training can help address these challenges and ensure effective contract management.

What are the key skills and qualifications needed to thrive as a PBM contracting specialist?

To thrive as a PBM (Pharmacy Benefit Manager) Contracting Specialist, you need a strong background in contract negotiation, healthcare regulations, and pharmacy benefit management, typically supported by a degree in business, pharmacy, or healthcare administration. Familiarity with contract management software, PBM platforms, and knowledge of Medicare/Medicaid regulations is essential. Exceptional attention to detail, strong communication, and analytical thinking are crucial soft skills for success in this role. These skills ensure contracts are negotiated effectively, compliance is maintained, and mutually beneficial relationships are fostered between PBMs and clients.
What cities in California are hiring for Pbm Contracting jobs? Cities in California with the most Pbm Contracting job openings:
Infographic showing various Pbm Contracting job openings in California as of August 2026, with employment types broken down into 89% Full Time, 5% Part Time, 2% Temporary, and 4% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution.

Formulary Consulting Group Lead - Remote

UnitedHealth Group

Irvine, CA • On-site, Remote

$112K - $193K/yr

Full-time

Retirement

Posted 29 days ago


UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

186th of 887 rated healthcare providers


Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
This role requires a clinical aptitude to support clients in the growing Formulary Management Services (FMS) business segment, including identification and quantification of opportunities to maximize pharmaceutical rebate revenues and evaluation of these opportunities via financial therapeutic class models using client-specific actual claims data.
Hours: Monday - Friday 8:00 AM - 5:00 PM
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Deliver value to clients through consultations and presentations that focus on formulary strategies to help clients achieve clinical and financial goals
  • Apply clinical and business knowledge to execute financial models to identify formulary strategies yielding payor cost-savings, which will require you to:
    • Evaluate client formularies and UM criteria
    • Read and understand client contracts and pharma contracts
    • Access and use pricing databases, formulary databases, billing databases, claims databases
    • Run, develop, and analyze client utilization and spending reports
  • Develop & present client-facing materials that are clear, concise, and effective; must be able to simplify complex subjects without compromising content
  • Work cross-functionally to understand end-to-end operations, and manage deliverables, expectations and timelines with internal and external partners
  • Contribute to team business objectives
  • Use soft skills to build and foster relationships with internal and external partners
  • Serve as a subject matter expert on assigned therapeutic class strategies
  • Actively pursue continuous quality and process improvement in self and work tasks
  • Up to 10% travel may be required

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • 2+ years of experience in three or more of the following:
  • Client management or client-facing role
  • Formulary operations, strategy, development
  • Clinical operations (P&T, UMs, pipeline)
  • Pharmacy plan design or new client implementation
  • Pharma manufacturer discounts contracting, billing, or modeling
  • Health plan/PBM financial modeling experience

Preferred Qualifications:
  • 5+ years of experience in a client-facing role
  • 3+ years of clinical experience (e.g Pharmacist, Nurse, physician)
  • Possesses excellent communication and interpersonal skills
  • Ability to deal comfortably with ambiguity, uncertainty and risk, and can make high-quality decisions with less than perfect information
  • Ability to change course quickly in a fast-paced environment
  • Ability to demonstrate resourcefulness, and have the ability to innovate and problem-solve with initiative and ingenuity

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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