Miami, FL · On-site
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Quick apply
Miami, FL · On-site
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Miami, FL · On-site
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Quick apply
Miami, FL · On-site
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Chesapeake, VA · On-site
Medical
Dental
Vision
Retirement
PTO
... TPA), pharmacy benefit manager (PBM), healthcare carrier, and wellness vendor. * Data Mining ... Analyze large, multi-source datasets (i.e. 401(k), medical/Rx, census, enrollment, payroll data ...
Chesapeake, VA · On-site
Medical
Dental
Vision
Retirement
PTO
... TPA), pharmacy benefit manager (PBM), healthcare carrier, and wellness vendor. * Data Mining ... Analyze large, multi-source datasets (i.e. 401(k), medical/Rx, census, enrollment, payroll data ...
Chesapeake, VA · On-site
Medical
Dental
Vision
Retirement
PTO
... TPA), pharmacy benefit manager (PBM), healthcare carrier, and wellness vendor. * Data Mining ... Analyze large, multi-source datasets (i.e. 401(k), medical/Rx, census, enrollment, payroll data ...
Chesapeake, VA · On-site
Medical
Dental
Vision
Retirement
PTO
... TPA), pharmacy benefit manager (PBM), healthcare carrier, and wellness vendor. * Data Mining ... Analyze large, multi-source datasets (i.e. 401(k), medical/Rx, census, enrollment, payroll data ...
Seattle, WA · Remote
$120K - $155K/yr
Medical
Dental
Vision
Life
Retirement
Preparing, conducting, and analyzing PBM RFPs, including specialty carve-out vendors as requested * Performing audits of pharmacy benefit management contracts and pharmacy benefits using PBM claims ...
Quick apply
Seattle, WA · Remote
$120K - $155K/yr
Medical
Dental
Vision
Life
Retirement
Preparing, conducting, and analyzing PBM RFPs, including specialty carve-out vendors as requested * Performing audits of pharmacy benefit management contracts and pharmacy benefits using PBM claims ...
Columbus, OH · On-site +1
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Columbus, OH · On-site +1
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Fulfill the essential promise of pharmacy care and help people to live to their healthiest ... Summary As a Benefit Analyst III, you will be accountable to provide support on the client benefit ...
Fulfill the essential promise of pharmacy care and help people to live to their healthiest ... Summary As a Benefit Analyst III, you will be accountable to provide support on the client benefit ...
Fulfill the essential promise of pharmacy care and help people to live to their healthiest ... Summary As a Benefit Analyst III, you will be accountable to provide support on the client benefit ...
Fulfill the essential promise of pharmacy care and help people to live to their healthiest ... Summary As a Benefit Analyst III, you will be accountable to provide support on the client benefit ...
Columbus, OH · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Columbus, OH · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
Hartford, CT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · Remote
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · Remote
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
Medical
Dental
Vision
Life
Retirement
PTO
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
$13.22 - $17.53
12% of jobs
$19.23 is the 25th percentile. Wages below this are outliers.
$17.53 - $21.83
32% of jobs
The median wage is $22.82 / hr.
$21.83 - $26.14
25% of jobs
$28.61 is the 75th percentile. Wages above this are outliers.
$26.14 - $30.44
10% of jobs
$30.44 - $34.75
9% of jobs
$34.75 - $39.05
5% of jobs
$39.05 - $43.36
2% of jobs
$43.36 - $47.66
0% of jobs
$47.66 - $51.97
0% of jobs
$51.97 - $56.27
0% of jobs
$56.27 - $60.58
4% of jobs
$13
$27
$60
A Pharmacy Benefit Analyst is responsible for evaluating and managing pharmacy benefits programs to ensure cost-effectiveness and compliance with regulations. They analyze prescription drug utilization, identify cost-saving opportunities, and collaborate with pharmacies, insurers, and healthcare providers. Their role includes reviewing claims data, monitoring formulary changes, and optimizing benefit structures to improve patient outcomes while controlling expenses.
To thrive as a Pharmacy Benefit Analyst, you need strong analytical skills, attention to detail, and a background in pharmacy, healthcare, or data analysis, often supported by a relevant degree. Familiarity with pharmacy benefit management (PBM) systems, claims processing software, and data analysis tools such as Excel or SQL is highly beneficial, and certifications like Certified Pharmacy Technician (CPhT) can be advantageous. Effective communication, problem-solving abilities, and teamwork are valuable soft skills, enabling successful collaboration with internal teams and external partners. These competencies are critical to accurately analyzing pharmacy programs, ensuring plan compliance, and recommending data-driven strategies for improved benefit outcomes.
A Pharmacy Benefit Analyst typically reviews pharmacy claims data, analyzes cost and utilization trends, and generates reports to support plan management decisions. They may also work closely with pharmacists, benefit managers, and other stakeholders to resolve discrepancies, investigate outliers, or implement new benefit designs. Daily tasks often include interpreting large sets of pharmacy data, troubleshooting system or claim issues, and presenting findings to team members or clients. This role is crucial in helping organizations optimize their pharmacy benefit offerings and maintain regulatory compliance.
Cities with the most Pharmacy Benefit Analyst job openings:
The most popular types of Pharmacy Benefit Analyst jobs are:
The top employers for Pharmacy Benefit Analyst jobs are:
States with the most job openings for Pharmacy Benefit Analyst jobs include:
The top searched job categories for Pharmacy Benefit Analyst jobs are:
Full-time
Re-posted 3 days ago
Specific job functions include:
· Review and understand PBM contracts for all relevant pricing terms
· Review and understand plan design documents provided by PBM or client
· Utilize company’s proprietary Compliance Model
· Calculate client contractual financial guarantees, admin fees, rebates and other terms as required by client contract
· Assemble audit reports and summarize findings
· Document all potential issues and track decisions
· Collaborate with account management and pharmacy consultants to discuss results with clients and vendors
· Provide documentation during follow-up negotiations and discussions
· Work with IT to further develop Compliance Model logic and capabilities
· Assist in other financial projects as needed
Requirements:
· Bachelor’s degree in Business, Finance, or other health related field
· At least 3 years of either a) pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms
· Working knowledge of the PBM industry and pharmacy benefit claims
Desired Skills:
· Proficient in Microsoft Office, with extensive experience working with Excel
· Basic SQL query building
· Strong verbal and written communication skills
· Detail-oriented
· Solid, independent worker (this position will likely be based in the applicant’s home)
· Pharmacy Technician Certification (preferred)
Leading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.
We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.
