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Pharmacy Benefit Manager Jobs (NOW HIRING)

Gallagher

Pharmacy Benefit Analyst

Indianapolis, IN · Remote

$90K - $100K/yr

As part of Gallagher, a global leader in insurance, risk management, and consulting, you'll be ... The Pharmacy Benefit Analyst will support the Pharmacy Division with the data analytics and ...

Quantum Recruiters Inc

Pharmacy Technician

Eugene, OR · On-site

$17.75 - $21.50/hr

Help to resolve pharmacy services and benefits inquiries through skillful knowledge of the pharmacy claims, medical claims, and utilization management platforms. * Initiate clinical review and ...

McLaren USA

Pharmacy Program Manager, Michigan

Flint, MI · On-site

$63.25 - $74.50/hr

The Pharmacy Program Manager is responsible for the end-to-end oversight of McLaren Health Plan's Pharmacy Benefit Manager (PBM) vendor relationship, contract compliance, and Rx program ...

McLaren

Pharmacy Program Manager, Michigan

Flint, MI · On-site

$63.25 - $74.50/hr

The Pharmacy Program Manager is responsible for the end-to-end oversight of McLaren Health Plan's Pharmacy Benefit Manager (PBM) vendor relationship, contract compliance, and Rx program ...

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How much do pharmacy benefit manager jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for pharmacy benefit manager in the United States is $19.23, according to ZipRecruiter salary data. Most workers in this role earn between $18.75 and $19.71 per hour, depending on experience, location, and employer.

What are some common challenges faced by pharmacy benefit managers when negotiating with pharmaceutical manufacturers and pharmacies?

Pharmacy Benefit Managers (PBMs) often navigate complex negotiations with both pharmaceutical manufacturers and pharmacy networks to secure favorable pricing and formulary placement. A key challenge is balancing cost savings for clients while ensuring access to necessary medications for members. PBMs must also stay updated on regulatory changes and manage potential conflicts of interest, all while maintaining transparent relationships with stakeholders. Successfully addressing these challenges requires strong analytical, negotiation, and communication skills, as well as a deep understanding of the pharmaceutical landscape.

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

To excel as a Pharmacy Benefit Manager (PBM), you need a robust understanding of pharmacy operations, healthcare regulations, and pharmacy benefit plan design, typically supported by a degree in pharmacy, healthcare administration, or a related field. Familiarity with pharmacy claims adjudication systems, data analytics tools, and compliance software is commonly required. Strong negotiation, analytical thinking, and relationship management skills help PBMs navigate partnerships with pharmacies, insurers, and clients. These competencies ensure cost-effective, compliant, and efficient management of prescription drug benefits for diverse populations.

What is the difference between Pharmacy Benefit Manager vs Pharmacist?

AspectPharmacy Benefit ManagerPharmacist
CredentialsTypically requires a bachelor's degree in health administration, pharmacy, or related field; certifications varyRequires a Doctor of Pharmacy (Pharm.D.) degree and licensure
Work EnvironmentCorporate offices, insurance companies, healthcare plansCommunity pharmacies, hospitals, clinics
Industry UsageHealth insurance, pharmacy benefit management companiesRetail pharmacy, hospital pharmacy
Primary FocusManaging prescription drug benefits, formulary management, cost controlDispensing medications, patient counseling, medication management

While Pharmacy Benefit Managers focus on managing prescription benefits and controlling costs for insurance providers, pharmacists are healthcare professionals who dispense medications and provide patient care. Both roles are essential in the pharmacy industry but serve different functions within the healthcare system.

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 industry knowledge to optimize pharmacy benefits and ensure efficient medication management.
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Pharmacy Benefit Manager jobs near you
Infographic showing various Pharmacy Benefit Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $39,999 per year, or $19.2 per hour.

Manager, Pharmacy Operations/Pharmacy Benefit Management (Remote)

Molina Healthcare

Remote

$129K/yr

Full-time

Posted 6 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 304 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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