PBM Compliance & Market Conduct Specialist

Financial Regulation; Montpelier (VT); On-site; USD 80,000 - 120,000; Full time

Job summary

The Vermont Department of Financial Regulation seeks a Market Conduct PBM Examiner to monitor and regulate Pharmacy Benefit Managers operating in the state. This role conducts examinations and investigations to assess compliance, including contract review and claims data analysis, with clear reporting and compliance planning responsibilities.

Ideal candidates bring several years of PBM regulatory experience, strong communication skills, and the ability to navigate complex regulatory situations

Qualifications

• Four years of experience in insurance regulation, market conduct examination, PBM compliance, or healthcare policy.
• Two years at supervisory or lead examiner level.
• Experience reviewing PBM contracts and analyzing pharmacy claims data.
• Strong communication and regulatory interpretation skills.
• Professional insurance regulation certifications preferred (APIR, PIR, MCM, AIE, CIE).

Responsibilities

• Monitor and regulate PBMs operating in Vermont.
• Conduct examinations and investigations to assess compliance with Vermont laws.
• Perform contract reviews and analyze pharmacy claims data.
• Prepare reports and help develop compliance plans for PBMs.

Skills

PBM experience

Regulatory analysis

Contract review

Claims data analysis

Strong communication

Education

Bachelor's degree in a relevant field

Job description

The Vermont Department of Financial Regulation seeks a Market Conduct PBM Examiner to monitor and regulate Pharmacy Benefit Managers operating in the state. This role conducts examinations and investigations to assess compliance, including contract review and claims data analysis, with clear reporting and compliance planning responsibilities.

Ideal candidates bring several years of PBM regulatory experience, strong communication skills, and the ability to navigate complex regulatory situations