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Pbm Implementation Jobs in Illinois (NOW HIRING)

Cardinal Health, Inc.

$88 - $138/hr

... contract implementation and ongoing account performance * Monitor market, reimbursement, and ... Established relationships with payer and PBM executives and a demonstrated ability to leverage ...

New

Bcbsa

Director, Trade Client Relations

Tennessee, IL · Remote

$155K - $175K/yr

Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation * Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and ...

New

Bcbsa

Director, Trade Client Relations

Ohio, IL · Remote

$155K - $175K/yr

Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation * Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and ...

New

Bcbsa

Director, Trade Client Relations

Virginia, IL · Remote

$155K - $175K/yr

Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation * Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and ...

New

Bcbsa

Director, Trade Client Relations

Chicago, IL · Remote

$155K - $175K/yr

Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation * Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and ...

Codal

Senior Product Manager, Pharmacy

Chicago, IL · Remote

$130K - $172K/yr

A working knowledge of the prescription (Rx) lifecycle, pharmacy benefit management (PBM), and ... implementation roadmaps. * Challenge client assumptions, identify product gaps, and recommend ...

Codal

Senior Product Manager, Pharmacy

Chicago, IL · Remote

$130K - $172K/yr

A working knowledge of the prescription (Rx) lifecycle, pharmacy benefit management (PBM), and ... implementation roadmaps. * Challenge client assumptions, identify product gaps, and recommend ...

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Pbm Implementation information

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

To thrive as a PBM Implementation Specialist, you need a solid understanding of pharmacy benefit management, project management skills, and familiarity with healthcare regulations, often supported by a relevant bachelor’s degree. Experience with PBM software platforms, data integration tools, and possibly certifications like PMP are highly valued. Outstanding problem-solving, attention to detail, and strong communication skills set top performers apart in this role. These skills are essential for ensuring seamless implementation of PBM solutions, minimizing errors, and maintaining compliance in a complex, regulated environment.

What is a PBM Implementation specialist?

A PBM Implementation specialist is a professional who manages and oversees the process of integrating pharmacy benefit management (PBM) services for clients, such as health plans or employers. Their role involves coordinating system setups, benefit configurations, and data transfers to ensure accurate and efficient delivery of prescription drug benefits. They work closely with internal teams and clients to understand requirements, resolve issues, and ensure a smooth transition to PBM services. Strong communication, project management, and technical skills are essential in this role.

What are some common challenges faced during PBM implementation projects, and how can they be addressed?

One of the main challenges in PBM (Pharmacy Benefit Management) implementation is coordinating between multiple stakeholders, such as clients, vendors, and internal IT teams, to ensure accurate data integration and system configuration. This role often requires managing tight deadlines and rapidly resolving issues that arise during system testing and member migration. To address these challenges, strong project management skills, clear communication, and a proactive approach to identifying potential risks are essential. Collaboration with cross-functional teams and maintaining detailed documentation can also help ensure a smooth implementation process.

What is the difference between Pbm Implementation vs Pbm Analyst?

AspectPbm ImplementationPbm Analyst
CredentialsRelevant certifications, technical skillsSame certifications, analytical skills
Work EnvironmentProject-based, cross-functional teamsData analysis, reporting focus
Industry UsageHealthcare, pharmacy benefit managementHealthcare, insurance, benefits analysis
Primary FocusImplementing PBM systems and processesAnalyzing data, generating insights

While both roles require similar credentials and operate within the healthcare and PBM industry, Pbm Implementation focuses on deploying and configuring PBM systems, whereas Pbm Analysts analyze data to optimize benefits and costs. The implementation role is more project-oriented, while analysts focus on data insights.

What are popular job titles related to Pbm Implementation jobs in Illinois? For Pbm Implementation jobs in Illinois, the most frequently searched job titles are:
What job categories do people searching Pbm Implementation jobs in Illinois look for? The top searched job categories for Pbm Implementation jobs in Illinois are:
What cities in Illinois are hiring for Pbm Implementation jobs? Cities in Illinois with the most Pbm Implementation job openings:
Pbm Implementation jobs near you
Infographic showing various Pbm Implementation job openings in Illinois as of August 2026, with employment types broken down into 87% Full Time, and 13% Contract. Highlights an 62% In-person, 13% Hybrid, and 25% Remote job distribution.

Insurance Verification Specialist (IDAHO)

Walgreens

Deerfield, IL • On-site

$16.50 - $22/hr

Full-time

Medical

Posted 6 days ago

Walgreens rating

5.5

Company rating: 5.5 out of 10

Based on 2,186 frontline employees who took The Breakroom Quiz

98th of 111 rated pharmacies

Job description


Job Summary:
Responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services. Handles inbound and outbound calls with customers, physician offices, patients or third-party providers about the company's products or services following standard SOPs and procedures, working under direct supervision. Ensures all contacts receive efficient and courteous service.
Job Responsibilities:
  • Respond to all levels of inbound Pharmacy Benefit Manager (PBM) and major medical insurance related phone calls.
  • Resolves questions and problems submitted by customers and Pharmacy Benefit Manager (PBM) following established guidelines and standard SOPs and procedures. Utilizes all available information to choose the best solution and resolve customer and PBM concerns.
  • Requests and loads PBM and/or Major Medical insurance plans.
  • Processes all non-clinical PBM rejections which may include but not limited to rejections for plan limits, coverage termed or prior authorization.
  • Assists physicians in the prior authorization process including initiation of prior authorizations.
  • May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans.
  • Verifies benefits for Major Medical via online resources or over the phone. Confirms network status, reviews FDA guidelines, and prior authorization requirements to ensure payment of claims.
  • Resolves questions and problems submitted by customers and Major Medical plans following established guidelines and standard SOPs and procedures. Utilizes all available information to choose best solutions and resolves customer and plan covers.
  • Facilitates the reimbursement windshields for PBM major medical claims.
  • Identifies and assesses individual customer or patient needs and provide education on or assist with grant applications, complex funding needs, commercial copay assistance enrollment along with appropriate action to satisfy those needs.
  • Provides primary support and expertise for specialized programs such as the patient assistance program or special handling.
  • Manages Pharma requirements including but not limited to warm transfers, bridge/quick start, enhanced prior authorization and appeal support.
  • May administer order queue such as Submission Problems or Waiting for Payment.
  • Documents contact interactions, records details, complaints, comments, and actions taken.
About Walgreens
Founded in 1901, Walgreens (www.walgreens.com) proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
External Basic Qualifications
  • High school diploma/GED
  • Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction in healthcare, specialty pharmacy, PBM, call center setting or other related industry
  • Ability to communicate clearly and effectively (written and verbal). Good interpersonal skills with the ability to communicate in a diplomatic and confidential manner
  • Basic level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).

Preferred Qualifications
  • Experience with providing customer service related to adherence, complex disease states quality, After Call Work (ACW), etc.
  • Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
  • Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
We will consider employment of qualified applicants with arrest and conviction records.
The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits

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