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Pbm Jobs in Wisconsin (NOW HIRING)

$142K - $177K/yr

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 ...

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General but functional understanding of pharmacy benefits management (PBM), self-funding and employee benefits. * Experience managing book of business in benefit industry - with a secondary emphasis ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Pharmacy Services Senior Director

Superior, WI · On-site

$123K - $163K/yr

You will thrive here if you have deep expertise in the business of pharmacy - payer and pharmacy benefit manager (PBM) dynamics, wholesaler and manufacturer relationships, pharmacy contracting, and ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Pharmacy Services Senior Director

Superior, WI · On-site

$123K - $163K/yr

Own pharmacy payer and PBM strategy. Serve as Essentia's primary partner with commercial payers, government payers, and pharmacy benefit managers, and build our negotiation approach to ensure we are ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

Automate and streamline reporting to increase efficiency and reduce manual processes within PBM pricing operations. * Contribute to Specialty Pricing operations by: * Managing pricing appeals ...

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Showing results 1-20

Pbm information

See Wisconsin salary details

$21.2K

$53.9K

$94.4K

How much do pbm jobs pay per year?

As of Jul 28, 2026, the average yearly pay for pbm in Wisconsin is $53,909.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,400.00 and $60,600.00 per year, depending on experience, location, and employer.

What is the highest paying job in B pharmacy?

In B pharmacy, the highest paying roles are often in pharmaceutical management, research and development, or regulatory affairs, which require advanced degrees and specialized skills. These positions typically offer higher salaries due to their expertise and responsibility levels.

What are some common challenges faced by Pharmacy Benefit Managers and how are they addressed?

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.

What are the key skills and qualifications needed to thrive in the Pbm position, and why are they important?

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.

How much does PBM make a month?

Pharmacy Benefit Managers (PBMs) typically earn between $4,000 and $8,000 per month for entry-level roles, with experienced professionals earning higher salaries. Compensation varies based on location, experience, and specific responsibilities within the organization.

What is the best PBM to work for?

Working as a pharmacy benefit manager (PBM) involves roles in pharmacy operations, claims processing, and formulary management. The best PBMs to work for are often large, well-established companies like CVS Health, Express Scripts, and OptumRx, which offer competitive benefits, career growth opportunities, and a focus on healthcare technology. Factors such as company culture, benefits, and job responsibilities should also be considered when evaluating employment options in this field.

What is a PBM job?

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.

What is a PBM job?

A PBM (Pharmacy Benefit Manager) job involves managing prescription drug benefits for health insurance plans, including negotiating with pharmacies and drug manufacturers, processing claims, and developing formularies. PBM professionals typically require knowledge of healthcare regulations, pharmacy operations, and may hold certifications in pharmacy or healthcare management.
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 jobs in Wisconsin? For Pbm jobs in Wisconsin, the most frequently searched job titles are:
What cities in Wisconsin are hiring for Pbm jobs? Cities in Wisconsin with the most Pbm job openings:
Infographic showing various Pbm job openings in Wisconsin as of July 2026, with employment types broken down into 84% Full Time, 8% Part Time, and 8% Temporary. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $53,909 per year, or $25.9 per hour.
Director, PBM Pharmacy Network Contracting

Director, PBM Pharmacy Network Contracting

Navitus Health Solutions, LLC

Madison, WI • Remote

$142K - $177K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 25 days ago


Navitus Health Solutions rating

7.0

Company rating: 7.0 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

264th of 488 rated business services


Job description

CompanyNavitusAbout UsNavitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.Pay RangeUSD $142,128.00 - USD $177,660.00 /Yr.STAR Bonus % (At Risk Maximum)15.00 - Director, GM of GP, PICWork Schedule Description (e.g. M-F 8am to 5pm)M-F: 8:00 am - 5:00 pmRemote Work NotificationATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.Overview

The Director, Pharmacy Network Contracting is responsible for leading the negotiation, execution, and ongoing management of pharmacy network contracts across all provider segments. This role holds direct accountability for contract strategy, provider agreements, and the financial outcomes of negotiated reimbursement structures.

The Director serves as the contracting authority for pharmacy provider agreements, leading negotiations with national chains, grocers, PSAOs, and independent pharmacies. This role ensures that contract terms are competitive, sustainable, and aligned with enterprise pricing strategy, regulatory requirements, and long-term network objectives.

This role partners closely with the Senior Director, Network Contracting to drive contracting strategy, establish negotiation priorities, and ensure alignment with enterprise network and financial objectives.

Is this you? Find out more below!  

Responsibilities

Network Contracting & Negotiation Leadership

  • Lead negotiation of pharmacy participation agreements across all provider segments, including national chains, grocers, PSAOs, and independent pharmacy networks.
  • Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements.
  • Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals.
  • Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
  • Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives.

Contract Strategy & Framework Development

  • Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives.
  • Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices.
  • Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics.
  • Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability.

Provider Engagement & Negotiation Strategy

  • Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
  • Serve as a senior point of contact for complex and strategic provider discussions, including reimbursement changes, contract interpretation, and structural alignment.
  • Maintain strong relationships with key pharmacy partners to support transparency, issue prevention, and alignment on contract expectations.
  • Drive resolution of high-impact or systemic provider issues, ensuring alignment to contract terms and enterprise objectives.

Contract Execution & Cross-Functional Alignment

  • Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation.
  • Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms.
  • Provide strategic guidance on contract interpretation to support claims configuration, pricing application, and network governance.
  • Support enterprise initiatives related to network strategy, growth, and regulatory readiness.

Financial Accountability & Performance Alignment

  • Accountable for financial performance of pharmacy network contracts, ensuring negotiated reimbursement terms align with enterprise pricing strategy and expected outcomes.
  • Partner with Network Performance and Reconciliation leadership to ensure contracted terms are operationalized and achieved through effective execution and monitoring.
  • Incorporate performance insights and market feedback into future negotiation strategies and contract design decisions.

Issue Resolution & Continuous Improvement

  • Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention.
  • Analyze trends in provider inquiries, disputes, and operational friction to identify opportunities for structural contract improvement.
  • Drive continuous improvement initiatives to enhance contract clarity, reduce administrative burden, and improve provider experience.

Leadership & Team Development

  • Provide leadership and direction to contract managers and/or senior contracting staff.
  • Set expectations for negotiation discipline, contract quality, documentation, and escalation standards.
  • Foster a high-performing team environment focused on accountability, consistency, and execution excellence.
Qualifications

What our team expects from you?  

  • Bachelor's degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
  • 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
  • Demonstrated experience in provider contracting, contract strategy, or network governance required.
  • Strong understanding of pharmacy reimbursement and claims adjudication concepts required. 
  • 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
  • Participate in, adhere to, and support compliance program objectives.
  • The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Navitus? 

  • Top of the industry benefits for Health, Dental, and Vision insurance 
  • 20 days paid time off 
  • 4 weeks paid parental leave 
  • 9 paid holidays 
  • 401K company match of up to 5% - No vesting requirement 
  • Adoption Assistance Program 
  • Flexible Spending Account 
  • Educational Assistance Plan and Professional Membership assistance 
  • Referral Bonus Program - up to $750! 

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Location : AddressREMTESTLocation : CityMadisonLocation : CountryUSEmployment Type: FULL_TIME

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