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Pbm Manager Jobs (NOW HIRING)

Gainwell Technologies

$91 - $130/hr

Experienced Test Manager - PBM Date: Aug 26, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) Great companies need great teams to propel their operations. Join the group ...

Vativo RX, LLC.

PBM Sales Executives

FL · Remote

PBM Sales Executive Job Summary The PBM Sales Executive (PBM) will be responsible for the sales ... Pharmacy Benefit Management That Fits You don't have to be a Fortune 500 company to enjoy the ...

Gainwell Technologies

WI · On-site

$91 - $130/hr

Experienced Test Manager - PBM Date: Aug 26, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) Great companies need great teams to propel their operations. Join the group ...

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How much do pbm manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for pbm manager in the United States is $78,680.00, according to ZipRecruiter salary data. Most workers in this role earn between $46,000.00 and $105,500.00 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.

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Cities with the most Pbm Manager job openings:

What are the most commonly searched types of Pbm jobs?

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What states have the most Pbm Manager jobs?

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Pbm Manager jobs near you
Infographic showing various Pbm Manager job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $78,680 per year, or $37.8 per hour.

PBM Partnerships & Payer Relations Manager

Insight

Flint, MI

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Insight Enterprises rating

8.3

Company rating: 8.3 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

45th of 226 rated it services

Job description

Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable, patient-centric care that is second to none. With a track record for innovation in healthcare, research and development, Insight Health System provides the communities we serve with world-class healthcare services at the forefront of medical technology. Our network currently includes a portfolio of entities encompassing six acute care hospitals (three of which are nonprofit), six surgery centers, 28 clinics, 580 physicians, 10 unions, and 4,200 employees. Collectively, Insight Health System hospitals provide nearly 100,000 patient days annually.
Position Overview
We are seeking a proactive, relationship-driven PBM Partnerships amp; Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers (PBMs), third-party administrators (TPAs), brokers, and self-funded employer groups. This role is responsible for building new partnerships, strengthening existing relationships, supporting contract execution, ensuring operational accuracy, and driving network growth across all payer and PBM channels. The ideal candidate excels at communication, problem-solving, and business development within the pharmacy or healthcare benefits ecosystem.
Benefits:
  • Comprehensive health, dental, and vision insurance
  • Paid time off: vacation, holidays, and sick leave
  • 401(k) with employer match (immediate vesting; eligibility begins after 3 months)
  • Employer - paid short - and long - term disability, basic life insurance
  • Voluntary coverages: accident, critical illness, hospital indemnity, AD amp;D, etc.

Key Responsibilities:

PBM Partnership Management
  • Serve as the main liaison for all PBM partners, contractors, TPAs, and associated vendors.
  • Manage onboarding, implementations, and ongoing communication to ensure alignment and strong operational performance.
  • Oversee contract execution, version control, and escalation resolution with external partners.
  • Proactively step in to assist with prior authorizations or operational duties as needed to ensure exceptional service continuity.
  • Maintain a clear understanding of PBM reimbursement strategies, plan designs, MAC pricing, and specialty pharmacy dynamics.
  • Step in to assist with PAs or operations during high-volume periods or staffing gaps.

Self-Funded Employer Network Development
  • Build new relationships with self-funded employers, brokers, benefits consultants, and employer coalitions.
  • Identify opportunities for employers to utilize the pharmacy as a preferred or direct-to-employer solution (specialty savings, infusion savings, carve-outs).
  • Present pharmacy value propositions, cost-savings models, and service offerings to employer groups.
  • Support the execution of direct-to-employer agreements and develop customized employer workflows.
Payer amp; Network Growth
  • Drive expansion into new PBM networks, payer groups, and employer health plans.
  • Research and pursue opportunities to improve reimbursement rates or negotiate favorable contract terms.
  • Track market trends, competitive pricing, and plan changes influencing pharmacy performance.
  • Strengthen ties with existing PBM and payer partners to secure long-term relationships.

Operational amp; Contract Coordination
  • Troubleshoot operational issues, adjudication errors, reimbursement discrepancies, and network constraints.
  • Collaborate with internal teams (legal, finance, operations, pharmacy) to ensure contractual accuracy and workflow alignment.
  • Maintain oversight of contract renewals, amendments, compliance obligations, and key dates.
  • Support renegotiation efforts by preparing comparisons, contract reviews, and partner summaries.

Performance Monitoring amp; Reporting
  • Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance metrics.
  • Generate internal reporting to evaluate partnership effectiveness and financial outcomes.
  • Identify opportunities to optimize pricing strategies, improve patient access, and enhance profitability.

Relationship Building amp; Strategic Development
  • Cultivate strong, trust-based relationships with PBM executives, employer decision-makers, consultants, and industry partners.
  • Represent the organization at meetings, conferences, and strategic discussions.
  • Identify emerging opportunities for collaboration, market expansion, or product/service enhancement.

Required Qualifications
  • Bachelor’s degree in Business, Healthcare Administration, Pharmacy, or a related field.
  • Experience working with PBMs, payers, networks, benefits administrators, or pharmacy operations.
  • Strong communication, negotiation, and relationship-management skills.
  • Ability to manage contracts, escalations, timelines, and multi-stakeholder relationships.
  • Strong analytical thinking, problem-solving skills, and organizational abilities.

Preferred Qualifications
  • Prior experience working directly with PBMs, TPAs, or self-funded employer groups.
  • Experience in specialty pharmacy, infusion services, or pharmacy network contracting.
  • Working knowledge of claim adjudication, reimbursement structures, MAC lists, spread pricing, and DIR fee models.
  • Experience building direct-to-employer pharmacy programs or benefit carve-out models.
  • Familiarity with value-based pharmacy programs, outcomes reporting, and data-driven performance metrics.
  • Strong understanding of healthcare contracting, payer policies, and benefits administration.
  • Ability to interpret contract terms, fee schedules, and reimbursement methodologies.
  • Experience presenting pharmacy solutions or savings programs to employers, payers, or consultants.
  • Existing relationships with PBMs, benefit brokers, employer groups, or industry partners is a major plus.

Insight is an equal opportunity employer and values workplace diversity!

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