PBM Compliance Analyst
Virtual Vocations Inc
Supporting regulatory compliance and reporting operations, the full-time PBM Compliance Analyst will manage federal and state regulatory filings, data validation, and audit readiness in a remote work environment. Key responsibilities Support federal and state regulatory reporting, ensuring timely submissions and compliance with pharmacy reporting requirements Collect, prepare, and validate data for regulatory filings, maintaining audit-ready documentation and responding to inquiries and audits Collaborate cross-functionally with various teams to monitor compliance workflows and manage project statuses effectively Required qualifications 1-3 years of experience in PBM operations, healthcare compliance, regulatory reporting, or data operations Proficiency in Excel, including VLOOKUP/XLOOKUP, Pivot Tables, and data validation techniques Foundational knowledge of CMS reporting requirements and state DOI reporting processes Experience with Jira, Confluence, or PBM Source is preferred Strong analytical and organizational skills with the ability to manage multiple projects and deadlines
- ...Health is seeking a detail-oriented Non-MAC analyst for the Non-MAC team to review and... ...complaints. The role emphasizes pricing compliance, data validation, market monitoring, and... ...activities. The ideal candidate has 4 years PBM experience, a Bachelor's degree, and proficiency...Suggested
$134.6k - $230.8k
...for everyone through people-led, responsible AI while Caring. Connecting. Growing together.The Director, Compliance leads operational compliance for the OptumRx PBM Commercial and Exchange lines of business across all 50 states by monitoring and supporting the business...SuggestedMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote work- ...Description Job Description Description: Job title: Formulary Compliance Analyst Location: Parsippany, NJ (Hybrid/Remote) Duration: 3... ...for identifying and investigating formulary positions on PBM and Health Plan websites and formal Pharmacy Drug Lists (PDL)...SuggestedContract workRemote workFlexible hoursShift work
- Prime Therapeutics is seeking a Senior Compliance Analyst to lead compliance oversight activities across assigned areas. This remote role supports enterprise compliance programs, monitors regulatory requirements, and partners with stakeholders to govern issues and corrective...SuggestedRemote job
- ...Lumicera is seeking an Analyst, Contract Operations to join its team. This data-driven role focuses on PBM and managed care contracting, translating complex claims data... ...functions. The position emphasizes contract compliance, reconciliation, RFP support, and cross-team...SuggestedContract workRemote work
$95k - $135k
...ABOUT THE ROLE: We are seeking a full-time Customer Success Analyst III to join our Data & Insights team. In this role, you’ll be... ...demonstrate our company’s impact to clients and strategic partners in the PBM space. You will support the development and execution of...Full timeWork experience placementNight shift- ...Supporting the Actuarial Forecasting and Analytics organization, the part-time Senior PBM Data Analyst will perform complex data analysis using advanced SQL and pharmacy benefit management (PBM) knowledge to enhance pricing and underwriting models. Key Responsibilities...Part timeRemote work
$150k - $190k
...Overview Position: Actuarial Consultant -(PBM) Location: Remote Salary: $150,000-190,000 + Bonus Actuarial Summary We are looking for an experienced Senior level Health Actuary with expertise in pharmacy benefit management (PBM) to guide a team of professionals...Remote work$96.8k - $121k
...PBM Data Analyst - HybridHealthcare Support is actively seeking a PBM Data Analyst - Hybrid to support a nationally recognized leader in healthcare. This company is a leader in providing benefit administration solutions to employers, unions, health plans, and government...Contract workWork at officeLocal areaImmediate startMonday to Friday- ...Senior PBM Data AnalystIndustry: Healthcare / Pharmacy Benefit Management Employment Type: Contract Openings: Multiple Location: RemoteAbout... ...benefit management organization seeking experienced Data Analysts to join its Enterprise Analytics team. This opportunity is ideal...Contract work
- ...actionable financial inputs for pricing and client projections, collaborating with Pharmacy and Health Actuarial teams. The role requires ASA with at least five years of actuarial or financial analytics experience in a PBM environment; FSA is preferred. #J-18808-Ljbffr...
$65k - $97.5k
...you to join our team to Bring the Future! Job Purpose The Compliance, Risk, & Law (CRL) Division is responsible for legal, trade-... ...Region (USA, Canada and Mexico) (HTNA). The Sr. Compliance Analyst supports the Governance, Risk, Compliance & Ethics Department...Full timeTemporary workWork experience placementInternshipRelocation package$65k - $85k
A healthcare consulting firm in the United States is hiring for an Analyst in PBM RFP Management. This role involves supporting the execution of projects, managing data, and preparing reports. Ideal candidates will have 1-5 years of experience in analytics or healthcare...$74k - $118k
...At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect... ...the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Medicare/Medicaid) - Remote Job Description The Senior Compliance...Full timeWork experience placementLocal areaRemote workVisa sponsorshipWork visa$74k - $118k
...At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect... ...the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Compliance Oversight Activities) - Remote Job Description...Full timeWork experience placementLocal areaRemote workVisa sponsorshipWork visa- ...Role: Healthcare Data Analyst PBM Data Modernization Location: Remote Industry: Pharmacy Benefit Management (PBM) Reports... ...working sessions with business users, pharmacy operations, and compliance teams to confirm definitions and resolve data questions....Remote work
- CornerStone Technology Talent Services is partnering with a growing PBM organization to hire a Senior PBM Data Analyst for its Enterprise Analytics team. The role emphasizes analyzing healthcare and pharmacy benefit data, developing SQL-based solutions, and delivering...Remote job
- Truveris is a pharmacy cost containment company hiring an Analyst, PBM RFP Management to help clients evaluate PBMs and prepare deliverables. You will collect and validate data, run competitive bids, and analyze pricing to highlight cost differences. The role requires...Remote work
- ...Job Description Summary \n The Senior Compliance Analyst works under the direction of the Chief Compliance Officer and serves as a key member of the Bank's Compliance Department. This position supports the Bank's risk-based Compliance Management System (CMS), with...Bank staffLocal area
- ...Mockingbird Towers 4th FLR Special Note: Strong candidates will have experience with Affordable Care Act ACA-related regulations, compliance requirements, reporting, or administration rather than simply having general healthcare experience. Work schedule: Hybrid /...Full timeWork at officeMonday to Friday
- ...embedded cyber resiliency and AI to protect today and enable tomorrow, all backed by the scale and strength of Spectrum. The Compliance Analyst VII supports RapidScale’s information security and regulatory compliance efforts within its Governance, Risk, and Compliance...Full timeWork experience placementLocal areaVisa sponsorship
$108.5k - $201.5k
...North Carolina), US #LI-Hybrid 3 days/week in officeInternal job title: Sr. Spec. DDIT ISC OperationsAbout the Role:The GRC Compliance Senior Analyst and support information security, risk, and compliance activities across business applications, IT/OT services, and...Full time3 days per week- ...Alliant Insurance Services in Irvine, CA is seeking a focused Project Manager to support the Mid-Market PBM solution within the pharmacy practice. You will coordinate with internal teams, track milestones, and ensure requirements, schedules, and budgets are met. The...Remote work
- ...What you will do to contribute to the company's successSubmit compliance filingsWork with financial and operational data related to internet... ...least an Associate degree for a Regulatory Compliance Analyst I position and a Bachelor's degree for the Regulatory Compliance...Full timeLive inRemote work
- ...company since going public in December 2021 while maintaining a strong balance sheet.Crescent Energy is seeking a Regulatory Compliance Analyst to support upstream and downstream operations in Texas and ensure compliance with the Texas Railroad Commission (RRC), and other...Full timeLocal area
- ...to identify requirements impacting HMSA operations.Assists management and Senior Analyst with interpreting complex requirements and translate them into actionable business and compliance strategies.Assists management and Senior Analyst with leading impact assessments to...Work experience placementWork at office
- ...Lumicera is seeking an Analyst, Contract Operations in New Jersey to optimize pharmaceutical manufacturer discounts and contracting programs... ...teams. The ideal candidate has 3–5 years of managed care or PBM experience, a Bachelor's degree, and familiarity with contract...Contract workRemote work
$79.1k - $104.8k
...Have This position actively participates in the organizations compliance risk management and operational excellence. Through monitoring... ...Skills & Experience Medicare Part D compliance experience. PBM/pharmacy operational knowledge. PBM/FDR oversight or PBM...Full timeFor contractorsFor subcontractorWork at officeRemote work2 days per week- ...Governance efforts. Responsibilities: The Senior ComplianceData Analyst’s primary focus will be to: Support the continued adoption of... ...data quality Produce source to destination data maps for AML compliance reports and systems Design periodic and adhoc supervisory reports...Temporary workWork at officeRemote workFlexible hours
$750 per month
...Overview Due to growth, we are adding an Analyst, Contract Operations to our team. This role... ...in pharmacy benefit management (PBM), managed care, pharmaceutical contracting... ...programs including, but not limited to contract compliance through direct pharmaceutical...Contract workRemote workFlexible hours
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