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Pharmacy Benefit Manager Jobs (NOW HIRING)

Lockton, Inc.

Pharmacy Data Analyst

Kansas City, MO · On-site

Review data for reasonableness, and validate data against key performance indicators collected from the Pharmacy Benefit Manager vendor (PBM) * Learn to perform pharmacy pricing guarantee ...

RI Council 94

$125 - $144/hr

Administer the Pharmacy Benefit Manager Regulatory Program. * Develop, implement, and oversee OHIC's PBM regulatory program. * Review and evaluate applications for certificates of authority, renewals ...

Partner with PPHP

Pharmacy Business Analyst

Support the negotiation and management of pharmacy network contracts with providers and pharmacy benefit managers (PBMs). * Collaboration and Communication : * Work closely with clinical teams ...

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How much do pharmacy benefit manager jobs pay per hour?

As of Sep 5, 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 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 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 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 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $39,999 per year, or $19.2 per hour.

Pharmacy Benefit Verification Specialist

Onco360

Indianapolis, IN • On-site

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 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 113 rated pharmacies

Job description

Full-Time position may work remotely but MUST HAVE ACTIVE INDIANA PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
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.
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 & 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 & 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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