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Pharmacy Benefit Analyst Jobs (NOW HIRING)

Barrow Wise Consulting

Pharmacy Consultant

MD · On-site

$90K - $150K/yr

Perform advanced data analysis to inform optimization of the pharmacy benefit design and contract requirements. * Develop independent cost estimates for new contracts and contract requirements ...

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How much do pharmacy benefit analyst jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for pharmacy benefit analyst in the United States is $27.61, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $30.53 per hour, depending on experience, location, and employer.

What is a pharmacy benefit analyst?

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.

What are the key skills and qualifications needed to thrive as a pharmacy benefit analyst?

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.

What are the typical responsibilities of a pharmacy benefit analyst?

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.

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Pharmacy Benefit Analyst jobs near you
Infographic showing various Pharmacy Benefit Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $57,426 per year, or $27.6 per hour.

Pharmacy Benefit Verification Specialist

Onco360

Indianapolis, IN • Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 112 rated pharmacies

Job description

Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Specialty Oncology Pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Full-Time position may work remotely but MUST HAVE ACTIVE INDIANA PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Shift times are between 8am and 8pm.
**Starting salary at $24HR and up**
Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.
We also offer quarterly incentive bonuses.
We offer a variety of benefits including:
  • Medical, Dental amp; Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short amp; long-term disability insurance
Pharmacy Benefit Verification Summary
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Pharmacy Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Licenses/Certifications
    • Required: Pharmacy Technician License/Registration with Board of Pharmacy, as required by state law
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
  • Behavior Competencies
    • Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill
Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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