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What are the key skills and qualifications needed to thrive as a PBM Implementation Specialist, and why are they important?

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 Michigan? For Pbm Implementation jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Pbm Implementation jobs in Michigan look for? The top searched job categories for Pbm Implementation jobs in Michigan are:
What cities in Michigan are hiring for Pbm Implementation jobs? Cities in Michigan with the most Pbm Implementation job openings:
Pbm Implementation jobs near you

Reporting Analyst, PBM

Marpai Administrators LLC

South Lyon, MI • Remote

$65K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Job description

Benefits:
  • 401(k)
  • 401(k) matching
  • Competitive salary
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

Marpai Administrators (Subsidiary of Marpai Inc. (NASDAQ: MRAI)) is a technology company transforming the Third Party Administration sector serving employers with self-funded health plans. Marpai Administrators (Marpai) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes.
ABOUT THE POSITION:
The Reporting Analyst, PBM reports to the Account Executive, MarpaiRx and is responsible for developing, maintaining, and validating pharmacy claims reporting, operational dashboards, and client-facing analytics. This role will support MarpaiRx by translating pharmacy claims data into accurate, actionable reporting used for implementation, client readiness, clinical programs, performance guarantees, RFP support, and ongoing operational monitoring. The Reporting Analyst will work in a fast-paced, dynamic work environment, collaborating with operations, claims, clinical, implementation, account management, sales, and vendor partners. This role requires strong analytical ability, attention to detail, technical reporting skills, and the ability to communicate data findings clearly to internal and external stakeholders
WHAT YOU WILL BE DOING:
  • Develop, maintain, and validate recurring pharmacy claims reports, dashboards, and client-facing reporting packages.
  • Analyze pharmacy claims data, utilization trends, drug spend, generic efficiency, savings opportunities, specialty utilization, clinical outcomes, and performance guarantee metrics.
  • Support implementation, go-live, RFP, finalist meeting, and client readiness reporting needs.
  • Partner with claims, clinical, operations, implementation, sales, account management, and vendor teams to understand reporting needs, data requirements, and business priorities.
  • Document reporting logic, data sources, assumptions, exclusions, and recurring processes to ensure consistency and audit readiness.
  • Identify reporting gaps, data quality issues, and opportunities to improve reporting accuracy, efficiency, and repeatability.
  • Provide interpretation and recommendations related to pharmacy reports, dashboards, and claims analytics.
  • Support ad hoc analysis related to claims activity, reject codes, pharmacy network performance, mail/retail/specialty channels, and client-specific reporting requests.
  • Maintain reporting request trackers, open questions, and follow-up items to ensure timely completion.
  • Remain current on PBM, pharmacy benefit, healthcare analytics, and reporting trends.
  • Other duties as required.

WHAT SUCCESS LOOKS LIKE:
  • Accurate, timely, and repeatable pharmacy reporting that supports MarpaiRx operations, client readiness, and business growth.
  • Standard reports and dashboards are delivered on time and validated for accuracy.
  • Internal teams have clear visibility into claims activity, savings, utilization, performance guarantees, clinical outcomes, and implementation reporting needs.
  • Client-facing and RFP reporting is professional, consistent, and aligned with MarpaiRx standards.
  • Reporting logic, assumptions, exclusions, and data sources are documented clearly.
  • Strong cross-functional collaboration, proactive communication, and effective follow-up on reporting requests.
  • Data quality issues and reporting gaps are identified early and escalated appropriately.

WHAT DO YOU NEED:
  • Minimum 3 years of reporting, analytics, pharmacy benefit, healthcare, TPA, PBM, or related experience preferred.
  • Four-year college degree preferred, or equivalent experience.
  • Experience working with healthcare, pharmacy, benefits, claims, or financial data preferred.
  • Strong Microsoft Excel skills, including formulas, pivot tables, lookups, data cleanup, and report formatting.
  • Experience with SQL, Power BI, Tableau, or other reporting/dashboard tools preferred.
  • Ability to analyze large data sets and convert findings into clear business insights.
  • Strong verbal and written communication skills to explain reporting outputs, assumptions, and recommendations.
  • Exceptional attention to detail and ability to validate data for accuracy.
  • Strong organizational and follow-up skills to manage recurring reports, ad hoc requests, and deadlines.
  • Ability to work independently in a fast-paced environment.
  • Knowledge of PBM concepts such as claims adjudication, NDCs, drug spend, AWP, rebates, generic dispensing rate, specialty drugs, mail order, retail pharmacy, reject codes, and performance guarantees preferred.

WORK REQUIREMENTS:
  • Fast-paced, dynamic work environment requiring the ability to be adaptive, innovative, and flexible.
  • Remote position.
  • Travel expectations minimal, unless needed for client or internal meetings.

WHY WORK AT MARPAI?
We have great benefits:
  • Generous PTO
  • Medical and Prescription
  • Health and Wellness Programs
  • EAP
  • FSA / HSA / Dependent Care
  • Dental
  • Vision
  • Life and Disability
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield
  • Identity Theft Protection

    Marpai is an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.