Pharmacy Benefit Manager (PBM) Analyst (Operations & Policy Analyst 3)

$68,964 - $105,972/Yr

Department Of Consumer And Business Services - Salem, OR

Full-time - Mid Level

Remote - Salem, OR

10,001+ employees

Administration of Economic Programs

About the position

The Pharmacy Benefit Manager (PBM) Analyst will play a crucial role in establishing compliance standards and procedures for Pharmacy Benefit Managers in Oregon. This position involves collaboration with various stakeholders to develop a new compliance unit aimed at protecting consumers and ensuring fair practices within the pharmacy benefit management industry.

Responsibilities

• Serve as the lead analyst and project manager for the PBM Compliance team.
• Develop market surveillance techniques and complaint investigation procedures.
• Investigate complaints against pharmacy benefit managers.
• Review business practices for compliance with relevant statutes.
• Work with regulated entities on remediation plans.
• Conduct stakeholder outreach and education.
• Document cases for referral to the enforcement team.
• Consult with the enforcement team on appropriate sanctions for regulated entities.

Requirements

• A bachelor's degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or a related degree.
• Four years of professional-level evaluative, analytical and planning work, or equivalent experience and education totaling seven years.

Nice-to-haves

• Exceptional ability to design, evaluate, and modify a new compliance program.
• Expert proficiency in public relations and strong oral and written communication skills.
• Proficient project management fundamentals and strong organizational skills.
• Strong interpersonal skills and experience facilitating meetings with diverse interests.
• Expert experience in policy development and understanding impacts of policy changes.
• Expert knowledge of health policy, health insurance regulation, health insurance plan design, and pharmacy procedures.

Benefits

• Rewarding work in a productive and creative environment.
• Work/life balance with 11 paid holidays a year.
• A competitive benefits package.
• Advancement and learning opportunities.
• Possible eligibility for the Public Service Loan Forgiveness Program.
• Eligibility for fully remote work after gaining proficiency.