PBM jobs

PBM Business Integration Specialist // Pharmacist // Raleigh, NC //

Hybrid in Raleigh, North Carolina

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2d ago

Job Title: PBM Business Integration Specialist (Pharmacist) Location: Raleigh, NC Duration: 12+ Months Seeking a Pharmacy SME with deep Medicaid PBM, DUR, PDL/MDRP, Prior Authorization, and clinical policy expertise to support a major Medicaid Enterprise PBM implementation.Role serves as a key business stakeholder, guiding requirements, business process docs, UAT scenarios, and PBM vendor onboarding.Must have strong knowledge of Medicaid pharmacy operations, drug rebate programs, PADP, pharmac

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Contract

Depends on Experience

Product Owner - PBM - SAFe Product Owner certified 6.0

Remote

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4d ago

5 years of Product Owner exp. PBM is a must STRONG ability to work with stakeholders on the Business and IT. Must have Agile / SAFe Product Owner certified 6.0 EPICS and user stories

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Contract

$60+

Business Systems Analyst - PBM - Health

Remote

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17d ago

BA II Must have experience with PBM.Candidates with NCPDP (National Council of Prescription Drugs Program - F6 experience would be a plusHIPAA knowledge required

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Contract

$50+

Business Analyst / PBM Platform / W2 / Pharmacy / Healthcare

Remote

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4d ago

Job Title: Business Analyst Location: Hybrid / Remote Duration: 6 Months (Possible for extension) Job Description We are seeking an experienced Business Analyst with strong knowledge of Pharmacy, PBM , and Healthcare systems. The ideal candidate will work closely with business stakeholders, product owners, and technical teams to gather, analyze, and translate requirements into actionable solutions that improve healthcare operations, pharmacy workflows, and PBM processes. Key Responsibilities Co

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Contract

$50 - $55

Product Owner- Pharmacy/PBM

Remote

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Yesterday

We are seeking a highly motivated Product Owner with strong experience in pharmacy, PBM, or specialty pharmacy products. The ideal candidate will work closely with stakeholders, business teams, and engineering to define, prioritize, and deliver innovative healthcare technology solutions that enhance patient outcomes, optimize pharmacy workflows, and support value-based care initiatives. Key Responsibilities Act as the primary liaison between business stakeholders, pharmacy operations, PBM clien

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Contract

Depends on Experience

Business Analyst - Pharmacy or PBM experience

Remote

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Yesterday

Urgently looking to hire Business Analyst- Fulltime or Contract About the Role We are seeking an experienced Business Analyst with a strong background in pharmacy operations or pharmacy benefit management (PBM), or specialty pharmacy products. The Business Analyst will play a critical role in bridging business needs with technical solutions, ensuring that systems and processes align with regulatory requirements and support patient-centered pharmacy services. Key Responsibilities Partner with bus

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Full-time

Depends on Experience

PBM Product Manger

Remote or Hybrid

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Today

Position Overview: Looking for a Product Manager to help drive work for the Integration Project. 8 - 10 yrs of experience needed in the following skills: organization, systems analysis, program management, product ownership, scrum master, Data Analytics/ writing queries, complex problem solving, driving delivery, project management, IT, vendor management, Additional skills: Member Experience/ Digital Day to day tasks: i. Collaborate to deliver the integration project ii. Specifically working wi

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Contract

$60-$80

PBM Business Integration Specialist

Hybrid in Raleigh, North Carolina

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Yesterday

No of Req. : 01 Position Title : PBM Business Integration Specialist Location : Raleigh, NC 27610 Work Arrangement : Hybrid- The candidate must be physically present in the United States and legally authorized to work. Candidate Present Location Required: Project Start : 12/01/2025 Project Duration : 9-12 Months with possible extension Salary/Rate : W-2 or 1099 Interview Type : Webcam Interview Only Client : Direct Background : Required References : 2 References Required Skills: Skills and Expe

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Contract

Depends on Experience

PBM Business Integration Specialist (Pharmacist) - HYBRID

Hybrid in Raleigh, North Carolina

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3d ago

Job Description: Crop to Crop resumes are accepted The PBM Business Integration Specialist will serve as a member of the DHHS Medicaid Enterprise System (MES) Program within Pharmacy Business space. The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. The PBM Business Integration Specialist, as a

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Contract

Depends on Experience

PBM Business Integration Specialist(Pharmacist)

Hybrid in Raleigh, North Carolina

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2d ago

Comtech is seeking a Business Integration Specialist to serve as a member of the DHHS Medicaid Enterprise System (MES) Program within Pharmacy Business space. The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. The PBM Business Integration Specialist, as a Business Subject Matter Expert, will ass

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Full-time

$0.01 - $55

SYNON Developer

Remote

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Yesterday

Job Title: SYNON Developer Location: Remote Duration: Long term Tax Term: W2 Required: Strong SYNON/COOL 2E coding skills. Experience with RxCLAIM or Healthcare PBM application. 3 - 5 Years of Experience with SYNON/COOL 2E , COBOL400, CL/400, CLLE, DB2/400. Strong troubleshooting skills, and diligence in the pursuit of issue resolutions. Code with a minimal amount of guidance and meet project deadlines. Maintain existing systems, document the current system flow and business logic, developme

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Contract, Third Party

Interoperability Consultant

Remote or Nashville, Tennessee

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Yesterday

Job Title Interoperability Consultant Job Location Remote Duration- 6+ Months Experience level- 10+ years Mandatory Skills Payers, PBM, HIPAA, Client Interaction Job Description Interact with Payers Good understanding of HIPAA, CMS, ONC Good understanding PBM & Payer Experienced consultants who have below areas of competency: 1. Deep knowledge of healthcare interoperability regulations (HIPAA, CMS, ONC). 2. Translate compliance requirements into technology solutions (e.g., HIPAA, CMS, O

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Part-time, Contract, Third Party

Interoperability Consultant- REMOTE

Remote or New York, New York

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Yesterday

Job Title: Interoperability Consultant Location: Remote Job Description: Experienced consultants who have below areas of competency: Deep knowledge of healthcare interoperability regulations (HIPAA, CMS, ONC). Translate compliance requirements into technology solutions (e.g., HIPAA, CMS, ONC, FHIR standards). Confirm and identify the technical solutions required for Prime. Participate in co-discovery sessions with our clients, conveying our approach and building clarity of the PBM's role. Best

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Contract, Third Party

Business Analyst- Pharmacy Systems

Remote or Hybrid in Pennsylvania

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Yesterday

We are seeking an experienced Business Analyst with strong knowledge of Pharmacy, PBM , and Healthcare systems. The ideal candidate will work closely with business stakeholders, product owners, and technical teams to gather, analyze, and translate requirements into actionable solutions that improve healthcare operations, pharmacy workflows, and PBM processes. Key Responsibilities: Collaborate with business stakeholders to gather and document requirements related to pharmacy services, PBM workflo

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Contract, Third Party

Depends on Experience

AI Lead/AI Architect with Health Insurance experience

Remote or Hybrid in Bloomfield, Connecticut

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17d ago

Job Title: Lead AI Architect Healthcare & Cloud Platforms Location: Bloomfield CT - Hybrid Experience Level: 13+ years Role Overview: We are seeking a highly experienced Lead Architect to drive enterprise-grade cloud Generative AI Platform initiatives in the Healthcare Payer and PBM (Pharmacy Benefit Management) space. This role demands a unique combination of technical leadership, domain knowledge, and client-facing communication skills. You will be instrumental in architecting and driving impl

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Contract

Depends on Experience

Data Modeler with Tibco - PP Copy is mandatory

Hybrid in Albany, New York

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Yesterday

72-months Data Modeling experience in designing underwriting, claims DataMarts, Data warehouse in Insurance industry (Workers Compensation and disability). 10 72-months experience with developing maintaining predictive systems written R or Python using TIBCO Spotfire/TERR. 10 72-months experience with TIBCO Spotfire Analyst, Web Player and Business Authors, using Iron Python, R, and Java Scripts. 10 72-months experience in developing, documenting, maintaining end-to-end ETL data pipeline (Inform

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Third Party, Contract

Depends on Experience

Senior SQL Developer/ Healthcare and Pharma Domain Must

Remote

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Yesterday

Position: Senior SQL Developer Location: Pittsburgh, PA (Remote) Duration: Long-Term Project Domain: Healthcare Position Overview: Senior SQL Developer to join our healthcare data engineering team. The candidate will play a key role in developing, optimizing, and maintaining SQL-based solutions supporting clinical, pharmacy, and operational systems. Key Responsibilities Develop, optimize, and maintain complex SQL Server stored procedures, functions, triggers, and views. Design and develop effi

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Contract

$55 - $60

Healthcare Interoperability Consultant

Remote

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Yesterday

Role: Healthcare Interoperability Consultant Location: Remote Duration : Long term Job Description:- Experienced consultants who have below areas of competency: Deep knowledge of healthcare interoperability regulations (HIPAA, CMS, ONC).Translate compliance requirements into technology solutions (e.g., HIPAA, CMS, ONC, FHIR standards)

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Contract

Depends on Experience

Database Architect

Albany, New York

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Yesterday

Title : System ArchitectLocation : Albany, NY ( Onsite )Exp : 5+ YearsClient : State of NY72-months Data Modeling experience in designing underwriting, claims DataMarts, Data warehouse in Insurance industry (Workers Compensation and disability). 72-months experience with developing maintaining predictive systems written R or Python using TIBCO Spotfire/TERR.72-months experience with TIBCO Spotfire Analyst, Web Player and Business Authors, using Iron Python, R, and Java Scripts.72-months experien

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Full-time

65 - 75

Data Modeling W/R Python & TIBCO - HBITS-07-14398

Albany, New York

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Yesterday

72-months Data Modeling experience in designing underwriting, claims DataMarts, Data warehouse in Insurance industry (Workers' Compensation and disability). 72-months experience with developing maintaining predictive systems written R or Python using TIBCO Spotfire/TERR. 72-months experience with TIBCO Spotfire Analyst, Web Player and Business Authors, using Iron Python, R, and Java Scripts. 72-months experience in developing, documenting, maintaining end-to-end ETL data pipeline (Information Bu

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Contract, Third Party

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