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Pbm Legal Jobs (NOW HIRING)

SmithRx

Pricing Strategy Director

Plano, TX

... PBM offers, with an emphasis on larger enterprise clients. In addition to the Sales and Proposals team, this person will collaborate closely with our Strategy, Partnerships, Legal, Supply Chain, and ...

WELLDYNE

Sr. Pricing Analyst

Collaborate cross-functionally with Sales, Client Services, Finance, Proposal, Legal, and PBM Operations to align pricing strategy with business objectives. * Ensure pricing activities comply with ...

SERVE YOU RX

Account Executive

Milwaukee, WI · Hybrid

... management (PBM) clients by overseeing program administration, client implementation/client ... legal coverage, pet insurance, paid parental leave, and 18 days of paid time off in your first year.

SERVE YOU RX

Compliance Analyst I

Milwaukee, WI · On-site +1

Read, analyze, and interpret common PBM and healthcare-specific terminology. * Read and know common legal terms. * Solid detail orientation to produce a high degree of accurate results. * Manage and ...

Serve You Rx

Compliance Analyst I

Milwaukee, WI · On-site

Read, analyze, and interpret common PBM and healthcare-specific terminology. * Read and know common legal terms. * Solid detail orientation to produce a high degree of accurate results. * Manage and ...

Amkor Technology

Sr. Manager, Benefits

Tempe, AZ · On-site

This role partners closely with Finance, Legal/Compliance, Payroll, HR Operations, and global HR ... Own vendor relationships and RFPs (medical TPA, PBM, stop-loss, 401(k) recordkeeper, leave ...

ProAct

Contract Administrator

Chicago, IL

Perform other legal assistant, legal drafting or paralegal duties as assigned. Education: * Minimum ... PBM/TPA experience ideal but not required) * Previous contract drafting position that required ...

Serve You Rx

Account Executive

Milwaukee, WI · On-site

... management (PBM) clients by overseeing program administration, client implementation/client ... legal coverage, pet insurance, paid parental leave, and 18 days of paid time off in your first year.

Prescryptive

OR · On-site

The solution offerings include direct and partner enabled pharmacy benefit management (PBM), Carve ... Partner closely with Product, Finance, Legal, Marketing, and Implementation to ensure deals are ...

Bcbsa

$130.60K - $172.60K/yr

Partner with legal, compliance, and regulatory teams to interpret policy changes and implement program adjustments necessary to maintain compliance and operational integrity. Vendor Governance & PBM ...

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How much do pbm legal jobs pay per year?

As of May 30, 2026, the average yearly pay for pbm legal in the United States is $55,419.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $62,500.00 per year, depending on experience, location, and employer.

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

To thrive as a PBM Legal professional, you need a strong background in healthcare law, regulatory compliance, and pharmacy benefit management, typically supported by a Juris Doctor (JD) and relevant legal licensure. Familiarity with PBM contracts, HIPAA regulations, Medicare/Medicaid requirements, and legal research tools is crucial. Strong analytical thinking, negotiation, and attention to detail help you navigate complex legal and regulatory environments. These skills are essential for ensuring compliance, minimizing legal risks, and supporting effective healthcare delivery.

What are some common challenges faced by professionals in PBM Legal roles, and how can they be managed effectively?

Professionals in PBM (Pharmacy Benefit Manager) Legal roles often navigate complex regulatory frameworks and rapidly evolving healthcare laws. A common challenge is staying current with federal and state regulations affecting drug pricing, reimbursement, and patient privacy. Additionally, PBM Legal professionals frequently advise cross-functional teams, requiring strong communication skills and the ability to translate legal requirements into practical business solutions. Building strong relationships with compliance, clinical, and operational teams can help manage risk and streamline legal review processes. Proactively participating in ongoing training and industry forums also helps legal professionals stay ahead of regulatory changes.

What are PBM Legal professionals?

PBM Legal professionals are legal experts who specialize in issues related to Pharmacy Benefit Managers (PBMs). They provide guidance on compliance, contracts, regulatory matters, and litigation involving PBMs and their relationships with pharmacies, drug manufacturers, health plans, and government agencies. Their work helps ensure that PBMs operate within the legal frameworks that govern drug pricing, reimbursement, and benefit management. PBM Legal professionals often stay updated with evolving healthcare laws and regulations to advise clients effectively.

What is the difference between Pbm Legal vs Pbm Analyst?

AspectPbm LegalPbm Analyst
Required CredentialsLegal degree, Juris Doctor (JD), bar admission often preferredUndergraduate degree in finance, economics, or related field; certifications like CFA may be advantageous
Work EnvironmentLegal firms, corporate legal departments, healthcare organizationsFinancial institutions, investment firms, healthcare payers
Employer & Industry UsageLegal and healthcare sectorsFinance, insurance, healthcare industries
Common Search & ComparisonLegal responsibilities, compliance, healthcare lawFinancial analysis, data interpretation, healthcare cost management

While Pbm Legal focuses on legal compliance, healthcare law, and regulatory issues, Pbm Analyst centers on financial data analysis, cost management, and payer strategies. Both roles are essential in healthcare organizations but serve different functions related to legal versus financial expertise.

Pharmacy Network Consultant Senior - Remote

Pharmacy Network Consultant Senior - Remote

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$74K - $118K/yr

Full-time

Posted 27 days ago

Prime Therapeutics rating

8.0

Company rating: 8.0 out of 10

Based on 43 frontline employees who took The Breakroom Quiz

14th of 97 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Pharmacy Network Consultant Senior - RemoteJob Description
The Pharmacy Network Consultant is responsible for development and management of Prime's retail, mail, and quality-based pharmacy networks. This position is responsible for the management of Prime's network vendor's contracting activities ensuring contracting initiatives are effective and completed in accordance to Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This position is responsible for representing Network Management on financial audits and network management projects.
Responsibilities
  • Negotiate market competitive low to medium-high complexity pharmacy agreements for assigned pharmacies across all channels including retail, mail, and quality-based channels and lines of business aligned to Supply Chain COGS strategies and compliant with Network Management policies
  • Create and manage network contracting campaigns with network vendor; analyze information and report contracting performance to Network Management leadership, Network Client Services, Network Financial Analytics, Supply Shared Services, Pharmacy FWA and Audit and other as identified; ensure all contracting initiatives meet competitive discounts and client goals for each campaign
  • Work with Prime's reporting and analytics teams to establish network reporting for Prime and vendor's pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations
  • Represent Network Management department in audits and on cross-functional projects or Network Client Services initiatives
  • Perform network development, network analysis and management activities supporting strategy and network management priorities and projects
  • Ensure all contractual obligations are in adherence with company policies, regulatory compliance and legal requirements and engage with Legal and Network Management leadership in negotiating non-standard contract language with pharmacies
  • Establish, develop, and maintain relationships with chain, PSAOs and independent pharmacy providers
  • Manage all legal-to-legal correspondences between Prime and Pharmacy Providers escalating to Prime Legal Counsel as required
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in finance, business, management, or related field of study, or equivalent combination of education and/or related work experience; HS diploma or GED is required
  • 5 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 3 years of managed care experience in medical or pharmacy network contracting

Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
  • Excellent verbal and written presentation skills
  • Ability to work independently and on highly complex contract language and agreements; strong attention to detail
  • Ability to establish rapport and build relationships at all levels within an organization
  • Enhanced organizational skills with the ability to work on multiple projects simultaneously
  • Demonstrated ability to problem solve and interpret complex data; ability to analyze network information and synthesize it into meaningful information for a variety for audiences
  • Ability to work with confidential data and maintain privacy
  • Ability to evaluate and interpret policies and procedures

Preferred Qualifications
  • Master's degree in business, healthcare or related area of study
  • Pharmacy contracting experience within a PBM or other related healthcare industry
  • Knowledge of and experience within PBM industry, Medicaid, and Medicare
  • Familiarity with contract language and pharmacy reimbursement methodologies
  • Experience negotiating pharmacy solicitation contracts

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $74,000.00 - $118,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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