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Pbm Manager Jobs in Wisconsin (NOW HIRING)

Network Health

Pharmacist

Brookfield, WI · On-site +1

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health

Pharmacist

Brookfield, WI · On-site +1

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health, Inc

Pharmacist

Menasha, WI · On-site +1

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health

Pharmacist

Menasha, WI · On-site +1

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health, Inc

Pharmacist

Brookfield, WI · On-site +1

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health

Pharmacist

Menasha, WI · On-site

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health

Pharmacist

Brookfield, WI · On-site

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Network Health WI

Pharmacist

Menasha, WI · On-site

PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes) * Participate in case management, disease ...

Gainwell Technologies

WI · On-site

$108K - $155K/yr

... MES, PBM, system implementation, modernization, or related healthcare delivery initiatives. * Demonstrated experience leading PMO governance across complex, multi-workstream programs, including ...

Navitus Health Solutions, LLC

Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost ...

SERVE YOU RX

Clinical PA Technician I

Milwaukee, WI · On-site +1

Serve You Rx is a full-service pharmacy benefit manager (PBM) with unquestionable flexibility and an unwavering commitment to doing what's best for its clients. With a fervent focus on those it ...

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All JobsPbm JobsPbm Manager JobsPbm Manager Jobs in Wisconsin

Pbm Manager information

See Wisconsin salary details

$22.4K

$71.8K

$137.9K

How much do pbm manager jobs pay per year?

As of Sep 12, 2026, the average yearly pay for pbm manager in Wisconsin is $71,845.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,004.00 and $96,335.00 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 Wisconsin?

The most popular types of Pbm jobs in Wisconsin are:

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

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

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

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

Pbm Manager jobs near you
Infographic showing various Pbm Manager job openings in Wisconsin as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $71,845 per year, or $34.5 per hour.

Pharmacist

Brookfield, WI • On-site, Remote

Network Health
Insurance Services • 201 - 500 employees
Learn more about Network Healthexternal

Full-time

Posted 25 days ago

Network Health rating

7.9

Company rating: 7.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

The Pharmacist is responsible for providing clinical support for NHP's pharmacy, quality, compliance and health management efforts. This may include Case Management, Disease Management, Medication Therapy Management, Drug Utilization Review and creation of Clinical Programs to outcomes and cost effective drug therapy. This role assists in the development and evaluation of the plan formulary and benefit designs, and reports and presents such information as part of the NHP P&T Committee.  The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and provider detailing. 

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required) in combination with at our office in Brookfield or Menasha, in our hybrid workplace model.

Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

  • Assist with Commercial compliance workplan oversite
  • PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes)
  • Participate in case management, disease management and poly-pharmacy for NHP patients with extraordinary high drug costs, including related services
  • Assist in providing physician education in areas of potential improvement i.e., create articles for pharmacy newsletter for NHP providers, speak to medical departments regarding drug issues, speak to individual NHP providers regarding drug issues including those for individual NHP members, participate in appropriate quality improvement projects, etc.
  • Assist with Concurrent DUR,Retrospective DUR, and MTM programs
  • Assist with formulary management and identifying UM criteria
  • Performs other duties and responsibilities as assigned

Job Requirements:

  • Current Pharmacist licensure without restriction by the State of Wisconsin Pharmacy Examining Board required
  • Bachelor of Science in Pharmacy required, Doctor of Pharmacy preferred.
  • A minimum of 3 years clinical experience
  • Residency/fellowship preferred. Managed care experience desirable
  • Prefer experience in at least one of the following areas:
    • Medication Therapy Management Programs
    • Long Term Care Pharmacy consulting
    • Decentralized hospital pharmacy services

Network Health is an Equal Opportunity Employer

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