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Pharmacy Benefit Management Jobs (NOW HIRING)

Actalent

Pharmacy Technician

Tempe, AZ · On-site

$20 - $23/hr

You will support the pharmacy benefit management process by reviewing requests, obtaining necessary clinical information, and ensuring timely and accurate decisions are documented and communicated to ...

Mercor

Pharmacy Access Specialist - Expert

New York, NY · Remote

$75/hr

Experience with speciality pharmacy platforms and pharmacy benefit management ( PBM ) systems. * Familiarity with Medicare Part D coverage determination and exception processes. * Exceptional written ...

Mercor

Pharmacy PA Specialist - Expert

San Francisco, CA · Remote

$75/hr

Experience with speciality pharmacy platforms and pharmacy benefit management ( PBM ) systems. * Familiarity with Medicare Part D coverage determination and exception processes. * Exceptional written ...

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How much do pharmacy benefit management jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for pharmacy benefit management in the United States is $19.27, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $20.43 per hour, depending on experience, location, and employer.

What is pharmacy benefit management?

Pharmacy Benefit Management (PBM) refers to third-party administrators that manage prescription drug benefits on behalf of health insurers, employers, and government programs. PBMs negotiate with drug manufacturers and pharmacies to control drug costs, develop formularies (lists of covered medications), and process prescription drug claims. Their main goal is to ensure patients have access to necessary medications while keeping costs manageable for all parties involved. PBMs also implement programs to promote the appropriate use of medications and improve health outcomes.

What are the key skills and qualifications needed to thrive in pharmacy benefit management?

To excel in Pharmacy Benefit Management (PBM), you need a solid understanding of pharmacy operations, healthcare regulations, and formulary management, often supported by a background in pharmacy, healthcare administration, or business. Familiarity with pharmacy claims processing systems, data analytics tools, and PBM software platforms is essential. Strong analytical thinking, attention to detail, and effective communication skills set top performers apart in this field. These competencies ensure efficient prescription benefit administration, cost management, and clear collaboration with clients and healthcare providers.

What are some common challenges faced by professionals working in pharmacy benefit management roles?

Professionals in Pharmacy Benefit Management often navigate the complexities of balancing cost containment with ensuring quality patient care. Managing relationships between pharmacies, insurers, and pharmaceutical manufacturers requires strong negotiation and communication skills. Additionally, staying updated with frequently changing regulations and drug formularies can be demanding. The fast-paced environment also means adapting quickly to new technologies and processes, making flexibility and continuous learning essential for success in this field.

What is the difference between Pharmacy Benefit Management vs Pharmacist?

AspectPharmacy Benefit ManagementPharmacist
CredentialsTypically requires a degree in health administration, business, or related field; certifications varyRequires a Doctor of Pharmacy (PharmD) degree and licensure
Work EnvironmentOffice settings, insurance companies, healthcare organizationsCommunity pharmacies, hospitals, clinics
Employer & IndustryHealth insurance companies, PBMs, healthcare providersPharmacies, hospitals, healthcare facilities
Primary FocusManaging prescription drug benefits, formulary management, cost controlDispensing medications, patient counseling, medication management

Pharmacy Benefit Management professionals focus on overseeing prescription drug benefits and controlling costs within insurance and healthcare organizations, while pharmacists are healthcare providers who dispense medications and advise patients. Both roles are essential in the pharmacy industry but serve different functions and require distinct qualifications.

What does a pharmacy benefit manager do?

A pharmacy benefit manager (PBM) is a healthcare professional or company that administers prescription drug plans for health insurers, employers, and government programs. They negotiate with drug manufacturers, develop formularies, process claims, and work to control drug costs and improve medication access. PBMs often use data analysis and pharmacy networks to manage medication benefits efficiently.
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Cities with the most Pharmacy Benefit Management job openings:

What states have the most Pharmacy Benefit Management jobs?

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Pharmacy Benefit Management jobs near you
Infographic showing various Pharmacy Benefit Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $40,074 per year, or $19.3 per hour.

Manager, Pharmacy Operations/Pharmacy Benefit Management (Remote)

Molina Healthcare

Remote

$129K/yr

Full-time

Posted 26 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

170th of 315 rated insurance

Job description


JOB DESCRIPTION Job Summary
Leads and manages team of pharmacy operations staff and Pharmacy Benefit Manager(PBM) activities. Responsible for oversight of delegated services, implementation of new products and services, and maintenance of business. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
Essential Job Duties
• Hires, trains, develops and manages team responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, and delivering products through the design process to completion.
• Supports Medicaid and Marketplace lines of business.
• Provides surveillance and oversight of delegated functions.
• Analyzes and interprets data to identify erroneous execution of the pharmacy benefit by the Pharmacy Benefit Manager (PBM).
• Reviews the daily inventory of "outliers" and remediates as required.
• Reviews protocols for accuracy and compliance, including: claims, contracts, overrides, network, digital, etc.
• Supports internal/external pharmacy audits.
• Monitors state and federal landscape for new opportunities.
• Collaborates with cross-functional partners to implement new products and services and supports maintenance of existing business.
• Develops and maintains requirements, user stories, test scenarios and test cases.
• Supports testing execution and defect management.
• Reviews and interprets member eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to both internal and external clients.
• Serves as PBM liaison for real-time support on pharmacy benefit interpretation or issues.
• Identifies and assists to remediate gaps and/or deficiencies in current pharmacy processes, tools, reports, and dashboards.
• Develops and maintains pharmacy job aids, policies, and process documents.
• Develops team members acumen in pharmacy services.
Required Qualifications
• At least 7 years of pharmacy experience, and at least 5 years of experience in Pharmacy Benefit Manager(PBM), and 4 years of experience in managed care, or equivalent combination of relevant education and experience.
• At least 1 year of health care management/leadership experience.
• Strong data analysis skills and attention to detail.
• Strong organizational and problem-solving skills.
• Knowledge of processes and systems, and ability develop and deliver necessary training to departmental staff and internal customers.
• Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies and vendors.
• Ability to meet established deadlines.
• Ability to function independently and manage multiple projects.
• Excellent verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
Preferred Qualifications
• Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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