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Pbm Manager Jobs in Florida (NOW HIRING)

HealthCare Support

Pharmacy Technician

Orlando, FL · On-site

$24.50 - $30.60/hr

... PBM organization in Orlando, FL. In this highly collaborative role, you'll serve as a trusted ... manage drug spend, and deliver measurable value. Schedule: * Monday-Friday, 8:30 AM-5:00 PM ...

eMed LLC

Director of Product

Miami, FL · On-site

$222K - $233K/yr

Familiarity with PBM workflows, pharmacy fulfillment, or employer health benefits * Experience managing products that serve both D2C and B2B customers simultaneously * Technical fluency with modern ...

Sedgwick

Vice President, Clinical Pharmacy

Tallahassee, FL · On-site

$111K - $147K/yr

QUALIFICATIONS Education & Licensing PharmD degree from an accredited university or school of pharmacy preferred or Bachelor's degree with commensurate experience in PBM management and health care ...

Actalent

Certified Pharmacy Technician

Orlando, FL · On-site

$16.75 - $20.50/hr

Enter coverage decisions accurately into the Pharmacy Benefit Management (PBM) system and other internal platforms. * Track coverage determination requests from receipt through final decision and ...

Elevance Health

Business Consultant

Tampa, FL · On-site

$87K - $131K/yr

Support strategic PBM Operations initiatives by evaluating operational impacts, implementation ... Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: BSP > Business ...

Elevance Health

Business Consultant

Miami, FL

$87K - $131K/yr

Support strategic PBM Operations initiatives by evaluating operational impacts, implementation ... Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the ...

eMed

Director of Product (Miami)

Miami, FL · On-site

$222K - $233K/yr

Experience with GLP‑1, weight management, chronic disease management, or telehealth * Familiarity with PBM workflows, pharmacy fulfillment, or employer health benefits * Experience managing ...

Elevance Health

Business Consultant

Tampa, FL

$87K - $131K/yr

Support strategic PBM Operations initiatives by evaluating operational impacts, implementation ... Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the ...

Elevance Health

Business Consultant

Miami, FL

$87K - $131K/yr

Support strategic PBM Operations initiatives by evaluating operational impacts, implementation ... Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: BSP > Business ...

OnePoint Patient Care

Pharmacist

Hollywood, FL · On-site

$53.25 - $64/hr

OnePoint fills prescriptions, creates custom compounds and formularies, provides home deliveries, and manages pharmacy benefits for thousands of patients per day. Through its Concierge PBM, Next Day ...

BrightSpring

Pharmacy Technician

Fort Myers, FL · On-site

$15.25 - $18.50/hr

OnePoint fills prescriptions, creates custom compounds and formularies, provides home deliveries, and manages pharmacy benefits for thousands of patients per day. Through its Concierge PBM, Next Day ...

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Showing results 21-40

All JobsPbm JobsPbm Manager JobsPbm Manager Jobs in Florida

Pbm Manager information

See Florida salary details

$19.5K

$62.7K

$120.3K

How much do pbm manager jobs pay per year?

As of Sep 8, 2026, the average yearly pay for pbm manager in Florida is $62,676.00, according to ZipRecruiter salary data. Most workers in this role earn between $36,643.00 and $84,040.00 per year, depending on experience, location, and employer.

What is a PBM manager?

A PBM Manager, or Pharmacy Benefit Manager Manager, is a professional responsible for overseeing the relationship between healthcare providers, insurance companies, and pharmacy benefit management companies. They work to ensure that prescription drug benefits are managed efficiently, negotiate contracts, and monitor compliance with regulations. PBM Managers analyze drug utilization data, manage formularies, and help control drug costs while ensuring patients have access to necessary medications. Their role is crucial in optimizing pharmacy benefit programs for employers, health plans, and other organizations.

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

To thrive as a PBM (Pharmacy Benefit Manager) Manager, you need a strong background in pharmacy operations, healthcare management, and a bachelor's degree in pharmacy, healthcare administration, or a related field. Familiarity with pharmacy benefit management systems, claims processing software, and regulatory compliance tools is crucial. Strong analytical skills, leadership, and effective communication are vital soft skills for collaborating with clients, vendors, and internal teams. These competencies are essential to optimize drug benefit programs, ensure regulatory compliance, and deliver value-driven healthcare solutions.

What are some common challenges PBM managers face when coordinating between pharmacies, insurers, and healthcare providers?

PBM Managers often encounter challenges related to balancing the interests of various stakeholders, such as negotiating contracts and ensuring formulary compliance while maintaining cost-effectiveness and patient satisfaction. They must navigate complex regulatory requirements and address discrepancies in drug pricing or reimbursement. Effective communication and problem-solving skills are essential, as the role frequently involves resolving issues that arise from claim disputes, prior authorization processes, and network management. Collaboration with cross-functional teams is key to streamlining operations and optimizing outcomes for all parties involved.

What is the difference between Pbm Manager vs Pbm Analyst?

AspectPbm ManagerPbm Analyst
CredentialsBachelor's degree, certifications like CPhT or PMP often preferredBachelor's degree, certifications like CPhT or relevant industry certifications
Work EnvironmentOversees teams, manages projects, strategic planningAnalyzes data, supports decision-making, reports generation
Employer & Industry UsagePharmacy benefit management companies, healthcare providersPharmacy benefit management companies, healthcare organizations

The Pbm Manager typically handles team leadership, strategic planning, and project management within pharmacy benefit management. In contrast, the Pbm Analyst focuses on data analysis, reporting, and supporting decision-making processes. Both roles require relevant certifications and work within similar healthcare environments, but the Manager has a broader leadership scope while the Analyst specializes in data-driven tasks.

What are the most commonly searched types of Pbm jobs in Florida?

The most popular types of Pbm jobs in Florida are:

What are popular job titles related to Pbm Manager jobs in Florida?

For Pbm Manager jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Pbm Manager jobs in Florida look for?

The top searched job categories for Pbm Manager jobs in Florida are:

What cities in Florida are hiring for Pbm Manager jobs?

Cities in Florida with the most Pbm Manager job openings:

Pbm Manager jobs near you
Infographic showing various Pbm Manager job openings in Florida as of August 2026, with employment types broken down into 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $62,676 per year, or $30.1 per hour.

MAC Appeals Specialist

LTC PHARMA HLDG LLC

Fort Lauderdale, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Key responsibilities

  • Monitor claims adjudication data to identify claims reimbursed below the pharmacy's acquisition cost or NADAC due to MAC pricing.

  • Compile MAC appeal packages and submit timely, well-documented appeals to PBMs.

  • Track the status of appeals, follow up on outstanding requests, and escalate denied or unresolved appeals as needed.

Job description

WHO WE ARE
At Polaris Pharmacy Services, we're more than a pharmacy - we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job - we provide competitive pay, robust benefits, and genuine opportunities for career advancement.
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.
JOB SUMMARY:
This role owns our Maximum Allowable Cost (MAC) and under reimbursement appeal process: identifying claims reimbursed below acquisition cost, building supporting documentation, and submitting timely appeals to PBMs to recover fair payment. This position requires sharp attention to detail, strong recordkeeping discipline, and confident, professional communication with PBM auditors and provider relations teams.
DUTIES/RESPONSIBILITIES:
MAC Appeals & Reimbursement Recovery
  • Monitor claims adjudication data to identify claims reimbursed below the pharmacy's acquisition cost or NADAC due to Maximum Allowable Cost (MAC) pricing.
  • Compile MAC appeal packages, including current wholesaler invoices, NDCs, and evidence of drug unavailability at the listed MAC price.
  • Submit timely, well-documented MAC appeals to PBMs in accordance with each payer's required format and appeal window.
  • Track the status of all submitted appeals, follow up on outstanding requests, and escalate denied or unresolved appeals as needed.
  • Analyze appeal outcomes and reimbursement trends to flag drugs/NDCs with chronic underpayment issues for ongoing appeal or formulary discussion.
  • Communicate directly with PBM provider relations and pricing teams to resolve disputes and confirm MAC list pricing updates once appeals are substantiated.
  • Report reimbursement recovery results, denial trends, and outstanding audit risk to pharmacy leadership on a regular basis.
  • Assist PBM and payer audit team in the collection of data such as hard-copy prescriptions, signature logs, proof-of-delivery records, wholesaler invoices, and inventory records - within each PBM's mandated turnaround time.
  • Stay current on each PBM's provider manual, network agreement terms, and audit appeal procedures and deadlines.

QUALIFICATIONS/COMPETENCIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
REQUIRED SKILLS/ABILITIES:
Required
  • High school diploma or GED required; Associate's or Bachelor's degree in a related field preferred.
  • Certified Pharmacy Technician (CPhT) license/certification preferred.
  • Working knowledge of NDC, NCPDP claim formats/rejection codes, and pharmacy claims adjudication processes.
  • Familiarity with MAC pricing, AWP/WAC benchmarks, and how PBM reimbursement and audit programs work from the pharmacy's side.
  • Comfort working with claims data in Excel.
  • Excellent written and verbal communication skills, including the ability to build a clear, well-supported case in an audit rebuttal or MAC appeal.
  • Highly organized and detail-oriented, with the ability to manage multiple audits, appeals, and deadlines across several PBM contracts at once.

Preferred
  • Prior experience specifically handling MAC appeals on behalf of a pharmacy.
  • Knowledge of state MAC transparency and appeals legislation, and pharmacy audit integrity laws (e.g., restrictions on extrapolation, recoupment timelines).
  • Experience working with pharmacy trade associations or third-party reimbursement consultants.

PHYSICAL DEMANDS
The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
  • May sit or stand seven (7) to ten (10) hours per day
  • The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
  • May be necessary to work extended hours as needed
  • May lift and/or move up to 30 pounds
  • The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY
  • Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
  • Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
  • Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.

Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.
BENEFITS for full time Employees
  • Medical, Dental, and Vision insurance
  • 401 (k) (available for Part Time & Full Time EEs)
  • Company Paid Life insurance
  • Short-term and Long-term disability insurance
  • Tuition reimbursement
  • Personal Time Off (PTO)
  • Competitive pay with annual performance reviews and merit-based raises
  • Career growth potential
  • Annual on-site voluntary Flu Vaccines
  • Employee referral bonus program

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