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Remote Pbm information

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 popular job titles related to Remote Pbm jobs in Raleigh, NC? For Remote Pbm jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Pbm jobs in Raleigh, NC look for? The top searched job categories for Remote Pbm jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Pbm jobs? Cities near Raleigh, NC with the most Remote Pbm job openings:
Remote Pbm jobs near you
Infographic showing various Remote Pbm job openings in Raleigh, NC as of July 2026, with employment types broken down into 6% Locum Tenens, 12% Internship, 66% Full Time, 4% Part Time, 2% Contract, and 10% Nights. Highlights an 75% Physical, 3% Hybrid, and 22% Remote job distribution.

Customer Service Supervisor PBM

Marpai Administrators LLC

Cary, NC • Remote

$58K - $65K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description


Marpai Administrators (Subsidiary of Marpai Inc. (NASDAQ: MRAI)) is a technology company transforming the Third Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
ABOUT THE POSITION: 
The Customer Service Supervisor, PBM reports to the Customer Service Manager and is responsible for leading a team of specialized agents, customer service representatives, to deliver high-quality service to resolve complex questions regarding prescription drug coverage. This role plays a critical part in enhancing customer satisfaction, driving retention, and supporting the overall business objectives by maintaining efficient operations and fostering a positive team environment. 
WHAT YOU WILL BE DOING: 
  • Supervise team: Guide the team through complex member inquiries regarding drug formularies, tier structures, and copays. Supervise the investigation and resolution with members, pharmacies and prescribers of rejected pharmacy claims, coordinating eligibility overrides and technical point-of-sale errors. 
  • Enforce compliance with regulatory requirements: Monitor and train teams on strict adherence to HIPAA regulations and other applicable regulations.
  • Monitor Key Performance Indicators (KPI) and Service Level Agreements (SLA): Ensure the team meets contractual SLAs. 
  • Training and Coaching: Analyze trends of issues to identify, training gaps, performance issues, and create a plan to address the gaps and recommend solutions as needed. Provide coaching and critical conversations to direct reports for developmental and correctional issues. 
  • Quality assurance and audits: Complete monthly call monitoring. Review monthly scorecard with individuals on team, identifying trends that need to be addressed as well as kudos for jobs well done.
  • Handles overflow for calls, chat, and emails as needed especially during peak
  • Maintain and develop Standard Operating Procedures
  • Other duties as required
 
WHAT SUCCESS LOOKS LIKE: 
  • Drive member accessibility through effectively managing resources, coordinating multiple daily tasks, and enhancing the effectiveness of customer interactions
  • Ensure exceptional quality through the monitoring and coaching of call interactions and claim processing
  • Cultivate the ultimate customer experience by ensuring the team is well trained and coached
  • Ensure team is meeting and exceeding expectations and metrics
 
WHAT DO YOU NEED:
  • Industry Experience: 2+ years of experience in a PBM, managed care, healthcare call center, or pharmacy environment.
  • Preferred License: Active Certified Pharmacy Technician (CPhT) designation or state pharmacy technician license is highly preferred. 
  • 3 years minimum call center experience
  • 3+ years in a supervisory or leadership role in a call center
  • Strong leadership and team management skills
  • Excellent communication, both verbal and written
  • Problem-solving and conflict resolution skills
  • Ability to analyze performance metrics and use data to improve team effectiveness
  • Encourage and support accountability and engagement, including sharing of information, ownership and successes with others
  • Consistently communicate expectations to clients and internal team members
  • Capability to manage service recovery as necessary

WORK REQUIREMENTS:
  • Tampa, FL or Remote
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • No travel required 
 
 WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • Health and Wellness Programs 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield 
  • Identity Theft Protection
       
    Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.