pbm jobs

Business Systems Analyst with PBM Experience

Los Angeles, California

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Today

Role: Sr Systems Analyst Location: Woodland Hills, CA (Hybrid from Day 1) Duration: 12 Months Job description: We are seeking a Senior System Analyst with strong PBM (Pharmacy Benefit Management) domain expertise to take on a lead role in establishing and managing operational processes for a newly transitioned function. This role requires a blend of data analysis, operational management, stakeholder communication, and coordination with IT and offshore teams. Key Responsibilities: * Analyze

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Contract, Third Party

Pharmacy Benefit Management (PBM) Subject Matter Expert (SME)

California

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23d ago

Candidate should have deep understanding of Pharmacy Benefit Management (PBM) business processes including Claims Adjudication, Data related processes (e.g. Eligibility data, Provider data, Drug data, Formulary data, Drug Utilization reviews) and their interconnections. Strong plus if candidate has experience with Electronic Prescriptions and Prior-Authorizations related standards. Deep understanding of related PBM standards from NCPDP. Strong plus if candidate also understands CMS regulations r

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Third Party

Test Analyst with PBM exp -Only EX CVS

Remote

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4d ago

Job Title- Test Analyst with PBM expRemote Job Description/ Responsibilities/ Years of experience- 4-5 years experience in Healthcare or a PBM desired. .NET C# experience as SDET Prioritize, manage multiple assignments, and direct the work of others to meet deadlines. Excellent communication (Verbal and Written) and collaboration skills. Superior organization, project management, and prioritization skills. Courteous and professional demeaner with the desire and ability to work as a team. Abili

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Contract

$40,000 - $50,000

Pharmacist - Pharmacy Advisor

Remote

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30+d ago

Position details: Position- Pharmacist - Pharmacy Advisor Location- Fully Remote Contract- 06 months contract with higher extension possibilities Shift: M-F & rotating Sat 8-hour shift starting between 8:00a - 11:00a CT. Training will be 8:00a-4:30p CT. Must be located in either AZ, HI, TX, IL, FL, or PA and have an active pharmacist license in that state Position Summary The role of the Clinical Pharmacist in the Pharmacy Advisor team, a specially developed, clinical program is to provide supp

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Contract

$50 - $55

Product Manager

Chicago, Illinois

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17d ago

Hi Everyone, Job Title: Product Manager (8 Positions) - PBM Experience is must Location: Chicago, IL Duration: 6 - 12 Months Job Description: As a Product Owner, you will be responsible for driving the vision for the product by being the voice of the customer, following a human-centered design approach. You will shape and manage the product roadmap and product backlog, ensuring the product team consistently delivers on the client''s needs and wants. You will validate and test ideas through recu

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Contract

65+

Product owner (Rxclaim/PBM)

Remote

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11d ago

Position: - Product owner (Rxclaim/PBM)Location: - RemoteType: - ContractJob DescriptionWe are seeking a highly experienced RxCLAIM Product Owner to lead the product vision, roadmap, and delivery for enterprise PBM solutions. The ideal candidate will have deep hands-on expertise in RxCLAIM, strong exposure to other PBM platforms, and a proven ability to work with business, clinical, and technology stakeholders to deliver scalable, compliant, and high-performing pharmacy solutions.This role requi

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Contract, Third Party

Depends on Experience

Senior Business Analyst with strong PBM

Woodland, California

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3d ago

Role: Senior System Analyst (PBM Domain) - Lead Level Location: Woodland hills, CA Mandatory areas Business Analyst 8 years of experience with strong PBM domain exposure (ideally 46+ years) Must Have skills: - Business analysis - Data analysis - Agile - Governance risk & compliance - Requirements gathering - User acceptance testing Mandatory, if Applicable Domain Experience (If any) Healthcare good to have. Role Overview: We are seeking a Senior System Analyst with strong PBM (Pharmacy Benefi

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Contract

Hiring: Product Manager Healthcare Technology & PBM

Remote

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2d ago

Hiring: Product Manager Healthcare Technology & PBM Location: Remote (USA Candidates must be currently based in the US) Client: Accenture (for CVS Caremark) We are looking for a high-impact Product Manager with deep expertise in Healthcare Technology & Pharmacy Benefit Management (PBM) to drive end-to-end product delivery across Medicare & Medicaid platforms. Key Responsibilities: Lead product lifecycle for PBM & healthcare systems (claims, eligibility, formulary, pricing & reimbursement) Driv

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Contract

50 - 60

.NET Developer / Pharma and PBM Domain is highly prefered

Remote

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22d ago

.NET Developer Job Summary: We are looking for a skilled .NET Developer with experience in designing, developing, and maintaining web applications using Microsoft technologies. The ideal candidate should have strong experience with C#, ASP.NET, .NET Core, SQL Server, and modern front-end technologies. Experience in the Pharma, Healthcare, or PBM (Pharmacy Benefit Management) domain is highly preferred. Roles & Responsibilities: Design, develop, test, and maintain .NET applications.Write clean, s

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Contract

$50 - $55

Principal Software Development Engineer (PBM AI Solutions)

Remote or Buffalo Grove, Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role Summary At CVS Health , you'll be working with a t

Full-time

USD 144,200.00 - 288,400.00 per year

Senior Manager - SRE - RunOps - PBM-IT

Remote or Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary PBM-IT Service Delivery - Senior Manag

Full-time

USD 130,295.00 - 260,590.00 per year

Senior Manager, Software Development Engineering (PBM Modernization)

Remote or Texas

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary The Senior Manager, Software Developme

Full-time

USD 106,605.00 - 260,590.00 per year

Senior Software Development Engineer (AS/400, RPG, Synon, Healthcare, PBM)

Dallas, Texas

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. As part of the Rx Claim FAB team, you will be expected t

Full-time

USD 92,700.00 - 203,940.00 per year

Staff Software Development Engineer (Java Architect, Healthcare, PBM)

Farmers Branch, Texas

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Today

Full-time

USD 118,450.00 - 260,590.00 per year

Senior Medicaid BI / Reporting Business Analyst (Remote)

Remote

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3d ago

Senior Medicaid BI / Reporting Business Analyst Location: Remote U.S. About Us: Known for Delighting the Client through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Why S2Tech?: Stable, privately-owned company with a strong reputation for

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Full-time

Depends on Experience

Project Manager - PBM - PMP - Claims / Medicare - Medicaid

Remote

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8d ago

PBM is a must. Pharmacy or Health PlansClient PortalsProvider Network Management and/or Clinical Programs. Claims Adjudication is always a plus.

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Contract

$60+

Lead Director, Software Development Engineering (Clinical AI Systems)

Buffalo Grove, Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary The Lead Director of Technology leads

Full-time

USD 144,200.00 - 288,400.00 per year

Customer Support Executive

Remote

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11d ago

Customer Support Engineer (Eligibility Team) Responsibilities: - Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic - - Data Interchange (EDI) protocol for clients - Researching and consulting to improve healthcare data integrity and ensure excellent service delivery - Constantly improving healthcare analytical skills that are needed to perform data analysis - Resolving data enrollment issues on a daily basis - Having exceptional time management and he

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Contract

Depends on Experience

Director, AI/ML Engineering - Remote

Remote or Eden Prairie, Minnesota

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Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. You'll enjoy

Full-time

USD 134,600.00 - 230,800.00 per year

Sr Backend Developer

Dallas, Texas

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16d ago

Job Title: Sr Backend DeveloperLocation: Chicago/NY/Dallas (Onsite) Required Qualifications5+ years of software development experience.Strong expertise in Java, Spring Boot, and Angular.Experience working with cloud platforms (Google Cloud Platform, Azure) and end-to-end DevOps pipelines.Solid foundation in data structures, algorithms, concurrency, and design patterns.3+ years building and maintaining RESTful APIs, microservices, and backend systems.Hands-on experience establishing and maintaini

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Third Party, Contract

Depends on Experience

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