S. payer/PBM. * Direct customer experience, consulting experience, and/or prior employment with CMS. * Strong strategic business acumen with extensive knowledge of the U.S. public and private payer ...
S. payer/PBM. * Direct customer experience, consulting experience, and/or prior employment with CMS. * Strong strategic business acumen with extensive knowledge of the U.S. public and private payer ...
Remote Pbm information
What is a remote PBM?
Remote PBMs, or Remote Pharmacy Benefit Managers, are professionals who manage prescription drug benefits for health plans, employers, and other groups from a remote location. They are responsible for ensuring that members receive appropriate, cost-effective medications while balancing the needs of both patients and payers. Remote PBMs work with pharmacies, insurance companies, and healthcare providers to process claims, negotiate pricing, and implement drug formulary policies. This role can be performed from home or other off-site locations using secure digital tools and platforms.
What are the key skills and qualifications needed to thrive as a remote Pharmacy Benefit Manager (PBM), and why are they important?
To thrive as a Remote Pharmacy Benefit Manager (PBM), you need a strong background in pharmacy, healthcare administration, or a related field, often supported by relevant degrees or certifications. Familiarity with pharmacy benefit management software, claims processing systems, and data analytics tools is typically required. Exceptional attention to detail, analytical thinking, and effective communication are crucial soft skills for collaborating with stakeholders and resolving complex issues remotely. These skills ensure accurate benefit administration, regulatory compliance, and positive outcomes for clients and patients in a remote work environment.
What are some common challenges faced by remote PBM professionals, and how can they be addressed?
Remote PBM professionals often encounter challenges such as maintaining effective communication with team members, staying updated on regulatory changes, and managing sensitive health information securely. To address these, it's important to leverage collaboration tools, participate in regular virtual meetings, and stay engaged with ongoing training. Additionally, adhering to best practices for data privacy and fostering strong relationships with both clients and pharmacies can help ensure smooth operations and job satisfaction.
What is the difference between Remote Pbm vs Remote Pharmacovigilance Associate?
| Aspect | Remote Pbm | Remote Pharmacovigilance Associate |
|---|---|---|
| Required Credentials | Pharmacy or healthcare background, certifications like CPR or pharmacy license | Healthcare degree, certifications in pharmacovigilance or drug safety |
| Work Environment | Remote, healthcare or pharmacy settings | Remote, pharmaceutical or biotech companies |
| Industry Usage | Pharmacy, healthcare providers, clinical settings | Pharmaceutical industry, drug safety departments |
| Common Search/Comparison | Remote Pbm vs Remote Pharmacovigilance Associate |
Remote Pbm roles focus on pharmacy benefit management, involving healthcare and insurance processes, while Remote Pharmacovigilance Associate positions are centered on drug safety and monitoring adverse effects in the pharmaceutical industry. Both roles are remote, require healthcare-related credentials, and are used within healthcare and pharma sectors, but they serve different functions within the industry.
More about Remote Pbm jobs
What are the most commonly searched types of Pbm jobs in Connecticut?
The most popular types of Pbm jobs in Connecticut are:
What are popular job titles related to Remote Pbm jobs in Connecticut?
For Remote Pbm jobs in Connecticut, the most frequently searched job titles are:
What job categories do people searching Remote Pbm jobs in Connecticut look for?
The top searched job categories for Remote Pbm jobs in Connecticut are:
What cities in Connecticut are hiring for Remote Pbm jobs?
Cities in Connecticut with the most Remote Pbm job openings:
ED, Centers for Medicare & Medicaid Services (CMS) - Remote
Ridgefield, CT • On-site, Remote
Full-time
Re-posted 19 days ago
Job description
Description
As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies' success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim's high regard for our employees.
The Executive Director, CMS is responsible for establishing the Centers for Medicare & Medicaid Services (CMS) - a federal agency within the Department of Health and Human Services - as a strategically managed enterprise account for Boehringer. In this role, the incumbent leads the development and execution of a comprehensive CMS account strategy that incorporates policy insights, reimbursement dynamics, and stakeholder engagement to inform portfolio-level access decisions. The Executive Director ensures CMS priorities, timelines, and expectations are proactively understood, anticipated, and integrated across the organization to mitigate financial risk and maximize long-term portfolio performance across Medicare and Medicaid.
This role also ensures that CMS policy direction, stakeholder dynamics, and implementation timelines are continuously assessed and translated into actionable, portfolio-wide strategies through close collaboration with Value & Access, Public and Government Affairs, Healthcare Affairs, and Commercial leadership.
Duties & Responsibilities
Enterprise CMS Account Strategy
Enterprise Stakeholder Leadership
CMS Relationship & Engagement Leadership
Policy & Market Insight Translation
Portfolio Access & Financial Risk Management
Requirements
Eligibility Requirements:
Compensation Data
The base salary range for this position is $250,000 and $394,000. The position may be eligible for a role-specific discretionary bonus, relocation, and/or other compensation elements. We continually review market data and may adjust salary ranges as needed in the future. Actual compensation will be based on job-related factors such as skills, experience, and qualifications, and other factors permitted by law.
As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies' success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim's high regard for our employees.
The Executive Director, CMS is responsible for establishing the Centers for Medicare & Medicaid Services (CMS) - a federal agency within the Department of Health and Human Services - as a strategically managed enterprise account for Boehringer. In this role, the incumbent leads the development and execution of a comprehensive CMS account strategy that incorporates policy insights, reimbursement dynamics, and stakeholder engagement to inform portfolio-level access decisions. The Executive Director ensures CMS priorities, timelines, and expectations are proactively understood, anticipated, and integrated across the organization to mitigate financial risk and maximize long-term portfolio performance across Medicare and Medicaid.
This role also ensures that CMS policy direction, stakeholder dynamics, and implementation timelines are continuously assessed and translated into actionable, portfolio-wide strategies through close collaboration with Value & Access, Public and Government Affairs, Healthcare Affairs, and Commercial leadership.
Duties & Responsibilities
Enterprise CMS Account Strategy
- Lead the development and execution of an enterprise-level CMS account strategy that integrates policy insights, reimbursement dynamics, and stakeholder intelligence.
- Inform portfolio-wide access and pricing decisions through proactive assessment of CMS direction and implications.
Enterprise Stakeholder Leadership
- Serve as the primary point of accountability for CMS engagement, ensuring coordinated, compliant, and purposeful interactions across Value & Access, Public and Government Affairs, Healthcare Affairs, Commercial, Legal, and senior leadership.
- Drive enterprise-level negotiation strategies that align with organizational priorities and long-term portfolio objectives.
- Align internal subject matter experts and external influencers to CMS priorities, ensuring cohesive messaging, engagement, and execution.
CMS Relationship & Engagement Leadership
- Establish and maintain senior-level, trust-based relationships with CMS and key external stakeholders.
- Lead strategic engagement planning aligned with CMS priorities, program direction, and implementation timelines.
- Represent the organization with credibility, consistency, and strategic foresight in all CMS-related interactions.
Policy & Market Insight Translation
- Monitor and interpret CMS policy direction, program updates, and emerging initiatives, including IRA implementation and evolving reimbursement frameworks.
- Translate policy developments into actionable, forward-looking strategies that support enterprise planning and execution.
- Communicate implications of CMS policy and programmatic shifts to cross-functional partners, ensuring coordinated preparation and response.
Portfolio Access & Financial Risk Management
- Assess enterprise-level access, reimbursement, and formulary risks across Medicare and Medicaid.
- Synthesize insights into data-driven recommendations for senior leadership, enabling informed decision-making and risk mitigation.
- Guide internal teams in understanding CMS impacts on current and future portfolio performance.
Requirements
- Bachelor's Degree required
- MBA/Graduate Degree in Health Care Management, Public Policy or other relevant certification preferred
- Minimum of 12 years of successful experience in policy, payer/government relations, large account management within the pharmaceutical payer/policy environment, or relevant experience with a U.S. payer/PBM.
- Direct customer experience, consulting experience, and/or prior employment with CMS.
- Strong strategic business acumen with extensive knowledge of the U.S. public and private payer landscape, the impact of healthcare reform (e.g., IRA), and the U.S. drug distribution channel.
- Proven negotiation skills, including the ability to navigate complex agreements and resolve potential disputes.
- Exceptional interpersonal and communication capabilities, with demonstrated ability to build relationships and influence key decision-makers.
- Advanced analytical, problem-solving, written, and verbal communication skills.
- Develops long-term, enterprise-level account strategies that reflect industry complexity and evolving customer priorities.
- Demonstrates strong executive presence in high-stakes internal and external engagements.
- Expands and leverages a broad stakeholder network, fostering connections that advance customer and enterprise needs.
- Aligns plans with strategic priorities to support organizational goals while mitigating risks and maximizing value for Boehringer.
- Creates win-win solutions during challenging discussions and negotiations.
- Facilitates open, transparent dialogue on customer needs and priorities among diverse internal and external stakeholders.
Eligibility Requirements:
- Must be legally authorized to work in the United States without restriction.
- Must be willing to take a drug test and post-offer physical (if required).
- Must be 18 years of age or older.
Compensation Data
The base salary range for this position is $250,000 and $394,000. The position may be eligible for a role-specific discretionary bonus, relocation, and/or other compensation elements. We continually review market data and may adjust salary ranges as needed in the future. Actual compensation will be based on job-related factors such as skills, experience, and qualifications, and other factors permitted by law.