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Pbm Manager Jobs in Northbrook, IL (NOW HIRING)

This role involves managing high-risk audits, investigating fraud or discrepancies, and presenting ... S. degree 3-5 years experience Experience as a Pharmacy Tech and project managment within PBM ideal ...

Senior Data Solutions Analyst

Chicago, IL · On-site

$88K - $111K/yr

ProAct - PBM is seeking a Senior Data Solutions Analyst to transform and organize data sets while ... management. Responsibilities : • Provide team leadership and guidance to Data Solutions Analysts ...

Our Company OnePoint Patient Care Overview The PBM Operations Support role performs a variety of tasks in support of the Pharmacy Benefit Management (PBM) department. This will include both daily ...

Formulary Management Pharmacist

Chicago, IL · On-site

$60 - $72.25/hr

Maintain and update formulary lists in compliance with health-plan, PBM, and regulatory standards. * Provide clinical support for utilization management, prior-authorization criteria, and step ...

Lead Business Consultant

Chicago, IL · On-site

$90 - $120/hr

Strong knowledge of PBM (Pharmacy Business Management) business processes which ensure smooth running for retail store operations. * Strong experience defining the metrics KPIs, SLAs, SLOs

Experience evaluating and explaining various PBM models, pricingtypesand products. * Strong understanding ofPBMcontracting life cycle. * Experience managing and updating CRM tools (i.e.,Salesforce ...

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Pbm Manager information

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 job categories do people searching Pbm Manager jobs in Northbrook, IL look for?

The top searched job categories for Pbm Manager jobs in Northbrook, IL are:

What cities near Northbrook, IL are hiring for Pbm Manager jobs?

Cities near Northbrook, IL with the most Pbm Manager job openings:

PBM Pricing Strategy Analyst Manager

Elevance Health

Chicago, IL

$102K - $177K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New


Elevance Health rating

7.6

Company rating: 7.6 out of 10

Based on 353 frontline employees who took The Breakroom Quiz

215th of 315 rated insurance


Job description

Anticipated End Date:

2026-09-11

Position Title:

PBM Pricing Strategy Analyst Manager

Job Description:

PBM Pricing Strategy Analyst Manager

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The PBM Pricing Strategy Analyst Manager will be responsible for Pharmacy Services pricing and Administrative Services Only (ASO) support functions.
How you will make an impact:

  • Implements new processes, process improvements, and best practices related to pricing, guarantee monitoring, and ASO pass back activities.
  • Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization and pharmacy pricing.
  • Creates tools and processes to monitor margin revenue, pricing accuracy, and client retention.
  • Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets.
  • Implements pricing in the system related to margin.
  • Supports the Pharmacy Services team in implementing future revenue, member expansion and growth capacity.
  • Assists with developing pharmacy pricing training to underwriters and updates to underwriting guidelines.


Minimum Requirements: Requires a BA/BS in Finance or related field and a minimum of 5 years of experience with a Pharmacy Benefits Manage (PBM), pricing, data analysis; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:

  • MBA strongly preferred.
  • Intermediate Excel experience and analytical skills strongly preferred.
  • Pharmacy underwriting/PBM experience strongly preferred.
  • Medical underwriting experience preferred.
  • Excellent verbal and written communication skills preferred.
  • Contraxx or similar contract management tool experience preferred.
  • Teradata experience preferred.
  • Domo experience preferred.
  • Prior leadership, coaching, and/or mentoring experience preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $102,640 to $177,054.

Locations: Illinois; Massachusetts; Minnesota; Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

AFA > Financial Operations

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.


What Elevance Health employees say

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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