Department Name and ID: Pharmacy Benefit Services
Reports to: PBM Product Lead
Effective Date: 05/01/2026
Job Summary:
Looking for someone that is interested in supporting a broad range of PBM functions including a blend of contract/compliance/marketing/proposal/ project management responsibilities.
From a contracting and compliance perspective, PBM SPM will focus on managing, negotiating, and ensuring the legal and operational integrity of Pharmacy Benefit Manager (PBM) agreements, while also monitoring compliance with applicable laws, regulations, and internal policies.
Within the marketing and proposal arena, PBM SPM will develop content and proposal responses to support new business needs, including managing active bids. In addition, SPM will be responsible for helping to build the infrastructure to support growth of proposal processes that incorporate best practices within the industry.
This is an opportunity to learn and grow under the guidance of the PBM lead, while applying your breadth and depth of knowledge within the PBM industry. It is an opportunity to leverage your greatest skills and broaden your knowledge of the PBM industry – all while supporting a fun, driven, and dynamic team.
Primary Responsibilities:
- Client Contracting/ Negotiation
- Vendor Contracting/ Negotiation and Performance Management
- Network Oversight/ Development
- Audits
- Contract Compliance
- Regulatory Compliance
- State Licensing
- Sales and Proposal Activity
- Proposal Content Development
- Finalist Support
- Marketing Collateral Development
- Website Development & Maintenance
- Underwriting
- Performance Guarantees
Educational Requirement:
- Bachelor’s degree in a related field (e.g., Paralegal Studies, Legal Studies, Business, or Healthcare Administration). Master’s degree preferred.
Required Experience:
- Minimum 5–7 years of PBM experience, with a focus on marketing/proposals/contract reviews, negotiations, and compliance. Additional tenure may be considered in lieu of education requirements.
Competencies:
- Excellent project management, analytical, organizational, and communication skills; attention to detail; ability to manage multiple projects in a fast-paced environment. Ability to learn quickly and drive change and growth within an organization.
- Leadership & Decision-making: Ability to lead and motivate project teams, make decisions with significant, broad implications for the future of the organization. Participates in decisions on the organization’s overall strategy and direction.
- Problem-Solving: Ability to address problems that are broad, complex, and abstract. Ability to bring solutions to the table that may require forward thinking and consideration of impact on team members.
- Independence of Action: Ability to set direction, vision, and workflow. Establishes timelines, manages deadlines and competing priorities.
- Written Communications: Ability to communicate complex information in English effectively in writing to all levels of staff, management, and external customers across functional areas.
- Oral Communications: Ability to verbally communicate complex concepts in English and address sensitive situations, resolve conflicts, negotiate, motivate, and persuade others.
- Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures, and policies and to use them in varied situations. Strong understanding of PBM operations, pharmacy benefit management, and relevant regulations (e.g., HIPAA, ACA, CMS guidance)
- Teamwork: Ability to lead collaborative teams for larger projects or groups both internal and external to the BILH System. Results have implications for the management and operations of multiple areas and future direction.
- Service Mindset: Proactive in anticipating needs of team members. Willingness to jump in to help others and tackle challenges head-on. Thoughtful in approach and building trust-based relationships with others.
Sensory Requirements:
- Close work (paperwork, visual examination), Color vision/perception, Visual monotony, Visual clarity <3 feet, Conversation, Monitoring Equipment, Telephone, Background Noise.
Physical Requirements:
- Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, and pulling objects. Sitting most of the time, with walking and standing required only occasionally. This job requires constant sitting, frequent Power Grasping using both hands, Fine Manipulation using both hands, Keyboard use. There may be occasional walking.