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Pbm Pharmacist Jobs in Raleigh, NC (NOW HIRING)

Omega Solutions Inc

Pharmacist

Raleigh, NC · On-site

PBM Business Integration Specialist The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and ...

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Pbm Pharmacist information

See Raleigh, NC salary details

$27

$59

$72

How much do pbm pharmacist jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for pbm pharmacist in Raleigh, NC is $59.21, according to ZipRecruiter salary data. Most workers in this role earn between $54.42 and $65.43 per hour, depending on experience, location, and employer.

What is the difference between Pbm Pharmacist vs Pharmacy Technician?

AspectPbm PharmacistPharmacy Technician
CredentialsDoctor of Pharmacy (PharmD) or equivalent, licensureHigh school diploma or equivalent, certification often preferred
Work EnvironmentHealthcare settings, insurance companies, PBM officesRetail pharmacies, hospitals, clinics
Job ResponsibilitiesFormulary management, medication therapy review, benefit designDispensing medications, customer service, inventory management

In summary, Pbm Pharmacists focus on medication benefit management, formulary decisions, and insurance-related tasks, requiring advanced pharmacy credentials. Pharmacy Technicians assist with dispensing and administrative tasks in pharmacy settings. Both roles are essential but differ significantly in responsibilities and qualifications.

What does a PBM pharmacist do?

As a PBM pharmacist, you fill prescriptions on behalf of a pharmacy benefit manager, which is a person or company that helps manage a program to provide a group of people—typically employees at one company—with prescription drugs. In this role, you may help negotiate prices with pharmaceutical manufacturers, evaluate contracts, and ship medicine through the mail or dedicated couriers. In some cases, you may even work in the same building as your clients—this is rare, but particularly large companies occasionally have on-site pharmacies run by a PBM. This job title refers to working as a pharmacist under a PBM and should not be confused with being the pharmacy benefit manager.

How does a PBM pharmacist typically collaborate with other healthcare professionals to optimize patient outcomes?

PBM Pharmacists regularly work with physicians, nurses, and pharmacy technicians to ensure that patients receive the most effective and affordable medications. They assess formulary options, provide clinical recommendations, and help resolve prior authorization or medication access issues. This collaborative approach not only improves patient care but also helps manage costs, making strong communication and teamwork skills essential for success in this role. PBM Pharmacists may also participate in clinical review committees and consult on drug utilization management.

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

To thrive as a PBM Pharmacist, you need a Doctor of Pharmacy (PharmD) degree, state licensure, and a strong understanding of managed care and formulary management. Familiarity with pharmacy benefit management systems, claims adjudication software, and data analysis tools is typically required. Critical thinking, attention to detail, and effective communication are crucial soft skills for collaborating with healthcare providers and ensuring optimal patient outcomes. These skills are essential for managing drug utilization, controlling costs, and maintaining compliance within the complex PBM environment.

What is a PBM pharmacist?

A PBM (Pharmacy Benefit Manager) pharmacist is a licensed pharmacist who works for a pharmacy benefit management company. Their primary responsibilities include reviewing prescription drug claims, ensuring medication safety and cost-effectiveness, managing formularies, and providing clinical support to clients and members. PBM pharmacists play a crucial role in optimizing medication therapy for large groups of patients, collaborating with healthcare providers, and helping to control prescription drug costs for employers and health plans.
More about Pbm Pharmacist jobs
What are the most commonly searched types of Pbm Pharmacist jobs in Raleigh, NC? The most popular types of Pbm Pharmacist jobs in Raleigh, NC are:
What are popular job titles related to Pbm Pharmacist jobs in Raleigh, NC? For Pbm Pharmacist jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Pbm Pharmacist jobs in Raleigh, NC look for? The top searched job categories for Pbm Pharmacist jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Pbm Pharmacist jobs? Cities near Raleigh, NC with the most Pbm Pharmacist job openings:
Pbm Pharmacist jobs near you
Infographic showing various Pbm Pharmacist job openings in Raleigh, NC as of August 2026, with employment types broken down into 2% Internship, 2% As Needed, 69% Full Time, 24% Part Time, and 3% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $123,157 per year, or $59.2 per hour.

PBM Business Integration Specialist (Pharmacist)

Expert Technology Services

Raleigh, NC • On-site

Contractor

Re-posted 25 days ago

Job description

NC Department of Health and Human Services (DHHS) seeks a Pharmacist as a Pharmacy Benefits Management (PBM) Business Integration Specialist to join the Medicaid Enterprise System (MES) project.
The PBM Business Integration Specialist will serve as a member of the DHHS Medicaid Enterprise System (MES) Program within Pharmacy Business space. The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. The PBM Business Integration Specialist, as a Business Subject Matter Expert, will assist the Department to on-board the PBM vendor, serve as a business stakeholder, and represent the Pharmacy Business Unit in the implementation of the complex and innovative PBM Solution.
The primary responsibility of this position is to serve as the subject matter expert and content lead in collaboration with the Pharmacy Business team for Clinical policies and Prior Authorizations, Drug Utilization Review (DUR) and pharmacy lock-in related processes, Behavioral health, and A+ kids, Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP), and Physicians Administered Drug Program (PADP) related to the Medicaid Drug Rebate Program (MDRP).
The Pharmacy team needs a Business Integration Specialist who is dedicated to the PBM Module Implementation and can focus on these work streams as they relate to implementation of the new PBM, in collaboration with the existing pharmacy team.
Knowledge of Medicaid Pharmacy Benefits Management processes, intended outcomes, and pain points is essential.
This position will actively work with the Pharmacy Business team to define and provide the business support in completing the business process documents, Business use cases, Business case scenarios, user acceptance test case scenarios, and documentation in relation to Medicaid initiatives and strategic goals. This position may require interacting with the NC Medicaid Business Information Analytics Office, DHHS Data Office, Information Technology Division, Privacy and Security Office, Policy Office, General Counsel, Office of Procurement, Contracts and Grants, among others.
Roles and Responsibilities
• Supports one or more Pharmacy business process areas, including.
o Clinical policies and Prior Authorizations.
o Drug Utilization Review (DUR) and pharmacy lock-in related processes
o Behavioral health, and A+ kids.
o Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP)
o Physicians Administered Drug Program (PADP) related to the Medicaid Drug Rebate Program (MDRP)
• Supports cross-functional activities that provide effective oversight of Medicaid Programs.
• Collaborates and communicates with the PBM Business stakeholders (Product Managers, Product Owners, Business Leads.)
• In-depth knowledge and understanding of the business needs across functions and business segments in healthcare that meet departmental goals.
• Ability to research and recommend the development and implementation of business initiatives of the product enhancements.
• Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solutions.
• Preferred to have experience with Medicaid, managed care, and Pharmacy Benefit Manager (PBM) operations. areas.
• Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.
• Communicate with the business owner needs and help translate them into detailed and actionable requirements as needed.
• Ensures compliance with all applicable policies and procedures.
• Supporting the product lifecycle from conception through implementation.
• Performs other duties as assigned.
In addition, the Pharmacy Business Integration Specialist is responsible in supporting the Business Management space to achieve successful development of the Pharmacy Benefit Management Solution in support of the Medicaid program. The Business Integration Specialist will work collaboratively with the Business owner and the rest of the business team to develop the strategy behind how each MES module will support the business requirements definition as well translation and specification of all functional requirements.
  Required/Desired Skills   SkillRequired /DesiredAmountof ExperienceGraduation from an accredited School of Pharmacy, B.S. or Doctor of Pharmacy degreeRequired0 Registered Pharmacist with a valid (active) and unrestricted Pharmacist licenseRequired3YearsLicensed to practice pharmacy in the State of North Carolina or the ability to receive the North Carolina license to practice Pharmacy within 90 daysRequired0 Understanding of pharmacy lines of business: retail, long term care, home infusion, mail order, specialty, institutionalRequired3YearsSkills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or managementRequired3YearsKnowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomesRequired3YearsDrug information skillsRequired3YearsExperience in ensuring with all applicable policies and procedures.Required3YearsKnowledge of the Enterprise IT Systems integration principle and associated change management best practicesDesired1YearsDemonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environmentRequired3YearsProficient in Microsoft Word, Excel, PowerPoint, Access, and Adobe softwareRequired3YearsExperience in reviewing and providing feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solRequired3YearsExperience working in a combination of business analysis. Product management, project management, and or software application developmentRequired3YearsExcellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex inRequired3YearsProven experience and working knowledge of the agile development methodologies, environment and toolsHighly desired2YearsExperience handling HIPPA and PII dataRequired3YearsManaged care knowledge or experienceRequired3YearsMedicaid program knowledge or related Healthcare Information experienceRequired3Years