Pharmacy Benefit Analyst

Job Description

Location: Remote (US-based)

We are hiring for a Pharmacy Benefit Analyst with a Pharmacy Benefit Analyst with a leading pharmacy benefit management company located in the US. This position is a full-time, direct hire opportunity.

This is an ideal opportunity for a pharmacy benefit or managed care analytics professional who wants to go beyond reports and influence formulary design, specialty drug strategy, and benefit plan performance. You will work cross-functionally with clinical pharmacists, account managers, and actuarial colleagues, giving you broad exposure to how a PBM operates end to end.

Responsibilities:

• Extract and analyze pharmacy claims data to identify high-cost utilization patterns and savings opportunities.
• Prepare drug review packages, therapeutic analyses, and financial models for formulary committee review.
• Model financial impact of formulary changes, tier placements, and PA criteria using claims and pricing data.
• Evaluate generic substitution and biosimilar opportunities; quantify savings and build adoption business cases.
• Produce recurring pharmacy benefit performance reports including spend trends, utilization rates, and compliance metrics.
• Respond to analytical requests from account, clinical, and executive teams with documented deliverables.
• Monitor CMS Part D, Medicaid PDL, and USPSTF updates; assess formulary compliance.
• Analyze specialty drug utilization trends and Limited Distribution Drug channel performance for optimization.
• Support rebate reconciliation by mapping formulary positions to contracted lists and validating eligibility.

Qualifications:

• Bring 3+ years pharmacy benefit management, analytics, or health plan operations experience.
• Master Excel (pivot tables, VLOOKUP, financial modeling) and SQL; SAS, Tableau, or Power BI a plus.
• Demonstrate formulary management knowledge: therapeutic reviews, utilization programs (PA, step therapy, quantity limits), tier architecture.
• Understand drug pricing benchmarks (AWP, WAC, NADAC), rebate mechanics, and PBM/plan/manufacturer contractual relationships.
• Demonstrate knowledge of Medicare Part D, Medicaid PDL, or commercial pharmacy benefit design; multi-line exposure preferred.
• Communicate analytical findings clearly to technical and non-technical audiences including plan sponsors.

Schedule:

• Full-time, Monday through Friday
• Fully remote, US-based candidates only
• Standard business hours with schedule flexibility

Salary Range: The salary range for this position is approximately $58,000 – $78,000 annually ($27.88 – $37.50 per hour), based on experience and qualifications.

Interview Process:

• Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.