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Remote Pbm Jobs in Wisconsin (NOW HIRING)

Navitus Health Solutions, LLC

$142K - $177K/yr

... manager (PBM) models. We are committed to removing cost from the drug supply chain to make ... Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

SERVE YOU RX

Compliance Analyst I

Milwaukee, WI · On-site +1

This position is open to remote. What You'll Do: As the Compliance Analyst , you will: * Research ... Prior pharmacy benefit management (PBM) or health insurance experience preferred. Competencies:

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

Maxor National Pharmacy Services

... PBM) setting. Partner cross-functionally with Underwriting, Finance, Clinical, and Account ... This is a remote-based position within the Continental US. Our Company Founded in 1926, Maxor is a ...

SERVE YOU RX

Clinical Account Executive

Milwaukee, WI · Remote

... management (PBM) clients and partners. This is accomplished by overseeing clinical program ... This is a remote position. What You'll Do: As the Clinical Account Executive, you will: * Actively ...

Bcbsa

$150K - $200K/yr

... plan or PBM. * Strong experience managing external audit vendors during audits * Strong ... The compensation for this role is budgeted between $150,000 and $200,000. #LI-Remote This is the ...

Navitus Health Solutions, LLC

... manager (PBM) models. We are committed to removing cost from the drug supply chain to make ... Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New ...

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All JobsPbm JobsRemote Pbm JobsRemote Pbm Jobs in Wisconsin

Remote Pbm information

See Wisconsin salary details

$12

$34

$70

How much do remote pbm jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for remote pbm in Wisconsin is $34.58, according to ZipRecruiter salary data. Most workers in this role earn between $16.90 and $45.66 per hour, depending on experience, location, and employer.

What Are Remote PBM Jobs?

Remote PBM jobs allow you to work from home while managing a pharmacy benefit management program. As a remote PBM analyst, consultant, or manager, your duties may include analyzing data to decide how to improve the program, using virtual office software to coordinate with assistants and other coworkers, negotiating to help lower pharmaceutical drug prices, and otherwise keeping a healthcare benefits program running. PBM interfaces support things like claims intake and pre-processing, clinical and medical management, analytics, and related systems to help ensure centralized control and management of the program. So, the ability to multitask and manage diverse processes is essential to success in these roles.

What are Remote PBMs?

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 (Pharmacy Benefit Manager) 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?

AspectRemote PbmRemote Pharmacovigilance Associate
Required CredentialsPharmacy or healthcare background, certifications like CPR or pharmacy licenseHealthcare degree, certifications in pharmacovigilance or drug safety
Work EnvironmentRemote, healthcare or pharmacy settingsRemote, pharmaceutical or biotech companies
Industry UsagePharmacy, healthcare providers, clinical settingsPharmaceutical industry, drug safety departments
Common Search/ComparisonRemote 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 Wisconsin? The most popular types of Pbm jobs in Wisconsin are:
What are popular job titles related to Remote Pbm jobs in Wisconsin? For Remote Pbm jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Pbm jobs in Wisconsin look for? The top searched job categories for Remote Pbm jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Pbm jobs? Cities in Wisconsin with the most Remote Pbm job openings:
Remote Pbm jobs near you
Infographic showing various Remote Pbm job openings in Wisconsin as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $71,923 per year, or $34.6 per hour.
Director, PBM Pharmacy Network Contracting

Director, PBM Pharmacy Network Contracting

Navitus Health Solutions, LLC

On-site, Remote

$142K - $177K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago

Navitus Health Solutions rating

7.0

Company rating: 7.0 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

263rd of 487 rated business services

Job description

Company
Navitus
About Us
Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
Pay Range
USD $142,128.00 - USD $177,660.00 /Yr.
STAR Bonus % (At Risk Maximum)
15.00 - Director, GM of GP, PIC
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F: 8:00 am - 5:00 pm
Remote Work Notification
ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Overview
The Director, Pharmacy Network Contracting is responsible for leading the negotiation, execution, and ongoing management of pharmacy network contracts across all provider segments. This role holds direct accountability for contract strategy, provider agreements, and the financial outcomes of negotiated reimbursement structures.
The Director serves as the contracting authority for pharmacy provider agreements, leading negotiations with national chains, grocers, PSAOs, and independent pharmacies. This role ensures that contract terms are competitive, sustainable, and aligned with enterprise pricing strategy, regulatory requirements, and long-term network objectives.
This role partners closely with the Senior Director, Network Contracting to drive contracting strategy, establish negotiation priorities, and ensure alignment with enterprise network and financial objectives.
Is this you? Find out more below!
Responsibilities
Network Contracting & Negotiation Leadership
  • Lead negotiation of pharmacy participation agreements across all provider segments, including national chains, grocers, PSAOs, and independent pharmacy networks.
  • Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements.
  • Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals.
  • Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
  • Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives.

Contract Strategy & Framework Development
  • Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives.
  • Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices.
  • Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics.
  • Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability.

Provider Engagement & Negotiation Strategy
  • Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
  • Serve as a senior point of contact for complex and strategic provider discussions, including reimbursement changes, contract interpretation, and structural alignment.
  • Maintain strong relationships with key pharmacy partners to support transparency, issue prevention, and alignment on contract expectations.
  • Drive resolution of high-impact or systemic provider issues, ensuring alignment to contract terms and enterprise objectives.

Contract Execution & Cross-Functional Alignment
  • Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation.
  • Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms.
  • Provide strategic guidance on contract interpretation to support claims configuration, pricing application, and network governance.
  • Support enterprise initiatives related to network strategy, growth, and regulatory readiness.

Financial Accountability & Performance Alignment
  • Accountable for financial performance of pharmacy network contracts, ensuring negotiated reimbursement terms align with enterprise pricing strategy and expected outcomes.
  • Partner with Network Performance and Reconciliation leadership to ensure contracted terms are operationalized and achieved through effective execution and monitoring.
  • Incorporate performance insights and market feedback into future negotiation strategies and contract design decisions.

Issue Resolution & Continuous Improvement
  • Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention.
  • Analyze trends in provider inquiries, disputes, and operational friction to identify opportunities for structural contract improvement.
  • Drive continuous improvement initiatives to enhance contract clarity, reduce administrative burden, and improve provider experience.

Leadership & Team Development
  • Provide leadership and direction to contract managers and/or senior contracting staff.
  • Set expectations for negotiation discipline, contract quality, documentation, and escalation standards.
  • Foster a high-performing team environment focused on accountability, consistency, and execution excellence.

Qualifications
What our team expects from you?
  • Bachelor's degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
  • 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
  • Demonstrated experience in provider contracting, contract strategy, or network governance required.
  • Strong understanding of pharmacy reimbursement and claims adjudication concepts required.
  • 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
  • Participate in, adhere to, and support compliance program objectives.
  • The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Navitus?
  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program - up to $750!

#LI-Remote
Location : Address
REMTEST
Location : City
Madison
Location : Country
US

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