Rx Claims SME
Eden Prairie, MN · On-site
Eden Prairie - MN; hybrid 1. In depth knowledge on RxClaim Adjudication, claims processing, MedD claims 2. Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug ...
Eden Prairie, MN · On-site
Eden Prairie - MN; hybrid 1. In depth knowledge on RxClaim Adjudication, claims processing, MedD claims 2. Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug ...
Eden Prairie, MN · On-site
Eden Prairie - MN; hybrid 1. In depth knowledge on RxClaim Adjudication, claims processing, MedD claims 2. Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug ...
Minneapolis, MN · On-site
$40 - $45/hr
Medical
Dental
Vision
Life
Retirement
Genesis10 is currently seeking a Business Side Project Manager with Healthcare/PBM for a 100% Remote contract to hire opportunity with a Major Healthcare Company. Compensation: $40.00 - $45.00 per ...
Minneapolis, MN · On-site
$40 - $45/hr
Medical
Dental
Vision
Life
Retirement
Genesis10 is currently seeking a Business Side Project Manager with Healthcare/PBM for a 100% Remote contract to hire opportunity with a Major Healthcare Company. Compensation: $40.00 - $45.00 per ...
Minneapolis, MN · On-site
Medical
Life
Retirement
PTO
Oversee a portfolio of assigned Health Plan and PBM clients, building and maintaining strong, long-term relationships. * Serve as the primary point of contact for assigned clients, coordinating ...
Minneapolis, MN · On-site
Medical
Life
Retirement
PTO
Oversee a portfolio of assigned Health Plan and PBM clients, building and maintaining strong, long-term relationships. * Serve as the primary point of contact for assigned clients, coordinating ...
Minneapolis, MN · On-site
Medical
Life
Provides detailed pharmacy analysis(es) working with the HUB analytics platform along with various partners and PBM's decision support tools to justify the election of theappropriate pharmacysolution
Minneapolis, MN · On-site
Medical
Life
Provides detailed pharmacy analysis(es) working with the HUB analytics platform along with various partners and PBM's decision support tools to justify the election of theappropriate pharmacysolution
Eden Prairie, MN · On-site
$118K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Eden Prairie, MN · On-site
$118K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Eden Prairie, MN · Remote
$112K - $193K/yr
Retirement
We are seeking a strategic and execution-focused Business Analyst to lead the process analysis across PBM Growth and Retention.. This role will be instrumental in driving modernization, data ...
Eden Prairie, MN · Remote
$112K - $193K/yr
Retirement
We are seeking a strategic and execution-focused Business Analyst to lead the process analysis across PBM Growth and Retention.. This role will be instrumental in driving modernization, data ...
Eden Prairie, MN · Remote
$118K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Eden Prairie, MN · Remote
$118K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Minneapolis, MN · On-site
Medical
Dental
Vision
Retirement
PTO
Review data for reasonableness, and validate data against key performance indicators collected from the Pharmacy Benefit Manager vendor (PBM) * Learn to perform pharmacy pricing guarantee ...
Minneapolis, MN · On-site
Medical
Dental
Vision
Retirement
PTO
Review data for reasonableness, and validate data against key performance indicators collected from the Pharmacy Benefit Manager vendor (PBM) * Learn to perform pharmacy pricing guarantee ...
Eden Prairie, MN · Remote
$60K - $107K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Eden Prairie, MN · Remote
$60K - $107K/yr
Retirement
Understanding of PBM processes, regulations, and industry standards * Strong skills in SQL and relational database tools You'll be rewarded and recognized for your performance in an environment that ...
Responsible for regular communication with community contract providers, RRC personnel, RRC residents, BOP physicians and healthcare providers, Pharmacy Benefit Management (PBM) providers and ...
New
Responsible for regular communication with community contract providers, RRC personnel, RRC residents, BOP physicians and healthcare providers, Pharmacy Benefit Management (PBM) providers and ...
New
Saint Anthony, MN · On-site
$64.50 - $85/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Saint Anthony, MN · On-site
$64.50 - $85/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Saint Louis Park, MN · On-site
$67.75 - $89.25/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Saint Louis Park, MN · On-site
$67.75 - $89.25/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Inver Grove Heights, MN · On-site
$65.75 - $86.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Inver Grove Heights, MN · On-site
$65.75 - $86.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
West Saint Paul, MN · On-site
$63.75 - $84/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
West Saint Paul, MN · On-site
$63.75 - $84/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Mendota, MN · On-site
$63.50 - $83.50/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Mendota, MN · On-site
$63.50 - $83.50/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Minneapolis, MN · On-site
$65.75 - $86.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Minneapolis, MN · On-site
$65.75 - $86.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Minnetonka, MN · On-site
$64.25 - $84.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Minnetonka, MN · On-site
$64.25 - $84.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Coon Rapids, MN · On-site
$65 - $85.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Coon Rapids, MN · On-site
$65 - $85.75/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Long Lake, MN · On-site
$61.50 - $81/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Long Lake, MN · On-site
$61.50 - $81/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Maple Grove, MN · On-site
$64.50 - $85/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
Maple Grove, MN · On-site
$64.50 - $85/hr
Preferred Skills * Healthcare payer/provider domain experience, including claims, premiums, PBM, capitation, risk adjustment, or stop-loss. * Workday Accounting Center, Prism, Worktags, and ...
New
$20.6K - $27K
2% of jobs
$27K - $33.5K
6% of jobs
$33.5K - $39.9K
16% of jobs
$40.3K is the 25th percentile. Wages below this are outliers.
$39.9K - $46.4K
17% of jobs
The median wage is $49K / yr.
$46.4K - $52.8K
23% of jobs
$57.6K is the 75th percentile. Wages above this are outliers.
$52.8K - $59.3K
16% of jobs
$59.3K - $65.8K
8% of jobs
$65.8K - $72.2K
6% of jobs
$72.2K - $78.7K
3% of jobs
$78.7K - $85.1K
1% of jobs
$85.1K - $91.6K
2% of jobs
$20.6K
$52.3K
$91.6K
Pharmacy Benefit Managers often encounter challenges such as staying compliant with frequently changing healthcare regulations, managing relationships between pharmacies, insurers, and clients, and controlling rising prescription drug costs. To address these challenges, PBMs work closely with cross-functional teams, leverage up-to-date technology platforms, and engage in ongoing education about regulatory requirements. Strong analytical skills help them assess and negotiate pricing strategies, while effective communication ensures all stakeholders are informed and aligned. By proactively managing these factors, PBMs play a key role in keeping healthcare affordable and accessible.
To thrive as a Pharmacy Benefit Manager (PBM), you need a solid understanding of pharmacy benefits, healthcare administration, insurance processes, and data analysis, often supported by a degree in pharmacy, healthcare management, or a related field. Familiarity with pharmacy claims processing systems, formulary management software, and compliance regulations is essential, and some roles may require pharmacy technician or pharmacist certification. Strong communication, negotiation, and organizational skills help PBMs collaborate with pharmacies, insurers, and clients while managing complex benefit structures. These capabilities are crucial for ensuring cost-effective, compliant, and efficient pharmacy benefit solutions for clients and patients.
A PBM (Pharmacy Benefit Manager) job involves managing prescription drug benefits on behalf of health insurers, employers, and other payers. Responsibilities often include negotiating drug prices with manufacturers, creating formularies, processing pharmacy claims, and ensuring medication cost savings. PBM professionals work in roles such as clinical pharmacists, account managers, and analysts to optimize drug coverage and improve patient outcomes.
The most popular types of Pbm jobs in Minnesota are:
For Pbm jobs in Minnesota, the most frequently searched job titles are:
The top searched job categories for Pbm jobs in Minnesota are:
Cities in Minnesota with the most Pbm job openings:

Full-time
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Software development
11 - 50 Employees
Tampa, FL, US