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Pharmacy Benefit Configuration Analyst Jobs (NOW HIRING)

Cim

Senior Configuration Analyst - Remote

Eden Prairie, MN · On-site

$91K - $163K/yr

We are looking for a Sr. HealthRules, Facets, or QNXT Configuration Analyst with experience in Product/Benefits, Pricing, Provider, and Claims. The Sr. HealthRules, Facets, or QNXT Configuration ...

Sentara Healthcare Inc

$106K - $176K/yr

Oversee the analysis, design, configuration, implementation, and maintenance of benefit plans within QNXT. * Ensure accurate configuration of products, plans, service codes, accumulators, limitations ...

Sentara Healthcare Inc

$106K - $176K/yr

Oversee the analysis, design, configuration, implementation, and maintenance of benefit plans within QNXT. * Ensure accurate configuration of products, plans, service codes, accumulators, limitations ...

Sentara Healthcare

Manager, Pharmacy Benefits

Richmond, VA · On-site +1

$64.25 - $75.75/hr

The ideal candidate will be able to motivate a remote team, have strong analytical skills, embrace ... leading pharmacy benefit configuration for all products. Acts as a liaison between internal ...

Wipro Limited

$38K - $83K/yr

Benefit Configuration Specialist City: Atlanta State/Province: California Posting Start Date: 8/19 ... the analysis and implementation of network database systems; provides technical guidance and ...

Avera Health

Configuration Analyst

Sioux Falls, SD · On-site

$63K - $96K/yr

As a Configuration Analyst you will work closely with clinical, operational, and technical ... Converting benefit plan requirements into system configurations, collaborating with other analysts ...

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Pharmacy Benefit Configuration Analyst information

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How much do pharmacy benefit configuration analyst jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for pharmacy benefit configuration analyst in the United States is $41.31, according to ZipRecruiter salary data. Most workers in this role earn between $30.53 and $52.88 per hour, depending on experience, location, and employer.

What is a pharmacy benefit configuration analyst?

Pharmacy Benefit Configuration Analysts are professionals who manage and configure pharmacy benefit plans within healthcare or insurance organizations. They ensure that prescription drug benefits are correctly set up in pharmacy benefit management (PBM) systems, aligning with plan designs and regulatory requirements. Their work involves analyzing benefit structures, troubleshooting issues, and collaborating with cross-functional teams to implement changes or updates. This role is essential for accurate claims processing and delivering the intended pharmacy benefits to members.

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

To thrive as a Pharmacy Benefit Configuration Analyst, you need strong analytical skills, attention to detail, and a background in pharmacy benefit management or healthcare, often supported by a relevant degree. Proficiency with pharmacy claims adjudication systems (such as Medispan or RxClaim), SQL, and understanding of benefit configuration tools is typically required. Excellent problem-solving abilities, communication skills, and the capacity to work collaboratively with cross-functional teams make someone stand out in this position. These skills are crucial to ensure accurate benefit setup, compliance, and efficient claims processing within pharmacy benefit programs.

What are some typical challenges pharmacy benefit configuration analysts face when implementing new plan designs?

Pharmacy Benefit Configuration Analysts often encounter challenges such as interpreting complex plan requirements, ensuring system configurations comply with regulatory standards, and accurately translating benefit designs into technical specifications. They must also collaborate closely with cross-functional teams, such as IT, clinical, and client services, to resolve ambiguities and address system limitations. Effective communication and attention to detail are crucial to prevent costly errors and ensure a smooth rollout of new or updated benefit plans.

What is the difference between Pharmacy Benefit Configuration Analyst vs Pharmacy Benefits Coordinator?

AspectPharmacy Benefit Configuration AnalystPharmacy Benefits Coordinator
Required CredentialsCertifications in pharmacy benefits, healthcare, or related fields; often a degree in health administration or pharmacySimilar certifications; often a background in pharmacy or healthcare administration
Work EnvironmentAnalyzing data, configuring pharmacy benefit plans, working with IT systemsCustomer service, plan administration, coordinating with providers and members
Employer & Industry UsageHealth insurance companies, pharmacy benefit managers, healthcare providersHealth plans, pharmacy benefit management firms, insurance companies

The Pharmacy Benefit Configuration Analyst primarily focuses on configuring and analyzing pharmacy benefit plans using data and IT systems, while the Pharmacy Benefits Coordinator handles plan administration and member interactions. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work environment.

What are popular job titles related to Pharmacy Benefit Configuration Analyst jobs?

For Pharmacy Benefit Configuration Analyst jobs, the most frequently searched job titles are:

Infographic showing various Pharmacy Benefit Configuration Analyst job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 78% Physical, 2% Hybrid, and 20% Remote job distribution, with an average salary of $85,935 per year, or $41.3 per hour.

Benefits Configuration Specialist I

Guaynabo, PR • On-site

Pharmpix
11 - 50 employees
Learn more about Pharmpixexternal

Full-time

Re-posted 4 days ago

Key responsibilities

  • Set up client benefit rules and configurations in the adjudication system for PharmPix clients.

  • Test claims and perform quality assurance reviews to verify system setup accuracy.

  • Act as a point of contact for system functionality and claim research questions from internal and external customers.

Job description

POSITION SUMMARY

The Benefit Configuration Specialist I report to the Benefits & Network Supervisor and is responsible for setting up business rules in the adjudication system for all PharmPix clients. The Benefit Configuration Specialist I will test claims and perform quality assurance reviews to ensure desired results.

 

ESSENTIAL ROLES AND RESPONSIBILITIES

 

  1. Perform accurate client benefit set up for all business rules for PharmPix clients.
  2. Implement new and maintain existing benefit plans, rates, and networks in the OneArk system, consistent with the direction and intent set forth by the client and PharmPix. 
  3. Properly enter test claims to verify business rules set up in the system.
  4. Perform quality assurance reviews on set up performed by other team members to ensure accuracy.
  5. Point of contact for both internal and external customers for system functionality and claim research questions.
  6. Become Subject Matter Expert on OneArk functionality to support the Operational areas and backend clients.
  7. Analyze client system requests and work to accommodate within existing systems before having to recommend system enhancements.
  8. Identify discrepancies, inaccuracies, and unintended consequences, and take corrective action. 
  9.  Research and respond to claims processing and system configuration inquiries from internal departments and backend clients. 
  10.  Proactively identify setup issues and escalate to the Benefit Implementation Director or Manager for immediate review and resolution. 
  11. Support all Quality Management Program initiatives.
  12. Perform other duties as assigned. 


TRAINING & EDUCATION

 

  • Pharmacy Technician Associate Degree or equivalent professional experience.

 

LICENSURE / CERTIFICATION

 

  • Puerto Rico Board of Pharmacy Technician Certification (Preferred). 

PROFESSIONAL EXPERIENCE

 

  • One (1) year experience in a PBM/Health Plan Environment (Preferred) or; Retail Pharmacy or; Proven working experience as a data analyst.

PROFESSIONAL COMPETENCIES

Knowledge:

  • Experience in the health insurance industry or PBM is desired. 
  • Knowledge of federal and The Commonwealth of Puerto Rico health care delivery and pharmacy regulations/regulatory agencies is preferred. 

 

Skills:

  • Must be detail-oriented and highly organized.
  • Accurately analyze and interpret common Pharmacy Benefit terminology.
  • Manage multiple priorities and work independently in a fast-paced environment.
  • Proficiency in Microsoft Office.
  • Possess a high degree of initiative, judgment, discretion, and decision-making to achieve organizational objectives.
  • Strong verbal, written and presentation communication skills.


Abilities: 

  • Ability to work independently and with minimal supervision, demonstrating initiative and problem-solving skills.
  • Able to effectively interact with internal departments, PharmPix clients and other healthcare professionals.
  • Ability to read and interpret documents, write reports and correspondence. 
  • Ability to organize and integrate organizational priorities and deadlines.
  • Ability to work independently or part of a team.
  • Fully bilingual English and Spanish.
  • Strong problem analysis and decision-making skills.


PHYSICAL AND MENTAL DEMANDS

 

  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear, sitting, standing, and walking
  • The position requires that weight be lifted, and force be exerted up to 25 pounds.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

ENVIRONMENTAL AND WORKING CONDITIONS

 

  • This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Require evening or weekend work.

PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans