Senior Project Manager - PBM

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

We are seeking an experienced Project Manager with a strong background in Pharmacy Benefit Management (PBM), technical project delivery, and testing coordination. The PBM Project Manager will be responsible for leading cross-functional initiatives that support pharmacy operations, system implementations, and testing efforts across PBM platforms.

This individual will partner with IT, business, and clinical teams to manage projects from concept through deployment, ensuring that solutions meet business needs, compliance standards, and quality expectations.

Your role in our mission

• Lead and manage PBM-related projects, including benefit configuration, claims adjudication system enhancements, formulary updates, and pharmacy network integrations.
• Develop and maintain project plans, timelines, and deliverables; monitor progress and report status to stakeholders.
• Collaborate with technical teams to define requirements, manage system configurations, and support data integrations and testing activities.
• Oversee end-to-end testing efforts (UAT, SIT, regression testing), ensuring business validation of system changes and enhancements.
• Identify project risks, issues, and dependencies; develop mitigation strategies and ensure timely resolution.
• Coordinate with pharmacy operations, clinical, and IT teams to implement benefit designs, pricing changes, and new PBM capabilities.
• Ensure projects meet compliance standards, including HIPAA, CMS, and state regulatory requirements.
• Facilitate meetings, document requirements, and maintain clear communication across technical and business stakeholders.
• Manage vendor relationships and ensure third-party deliverables align with project timelines and quality standards.

What we're looking for

• Bachelor's degree in Pharmacy, Computer Science, Information Systems, Healthcare Administration, or related field (or equivalent work experience).
• 5+ years of project management experience within Pharmacy Benefit Management (PBM), healthcare, or payer environment.
• Strong understanding of PBM operations, including claims processing, formulary management, benefit configuration, and pharmacy reimbursement.
• Experience managing system implementations, data integrations, and software testing cycles.
• Proficient in testing coordination, including test planning, test case validation, and defect management.
• Strong technical aptitude-able to collaborate with IT teams on requirements, data mapping, and interface testing.
• Excellent communication, organizational, and problem-solving skills.
• PMP or Agile/Scrum certification a plus.

What you should expect in this role

• Remote position (US only)
• Opportunities to travel through your work (0-10%)
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• The deadline to submit applications for this posting is 1/30/2026

The pay range for this position is $69,000 - $99,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.