Pharmacy Benefit Management Examiner

Examination Resources, LLC; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Examination Resources, LLC is seeking an experienced professional to support PBM regulatory examinations and related audits. The role emphasizes leadership, analytical thinking, and precise documentation in a largely remote environment.

The position requires strong research and writing skills, familiarity with NAIC guidelines, and the ability to interact with stakeholders. Travel is occasional, with remote work as a core modality for this role.

Qualifications

• Prior PBM audit or operations experience required.
• PBM industry professionals encouraged to apply (CPBS, CPhT, etc.).
• Experience completing examinations in accordance with NAIC Market Regulation Handbook, or experience as an attorney, accountant, auditor, examiner or analyst with a state insurance department, public accounting firm, PBM, insurance company, or state/Federal agency preferred.
• Ability to obtain the Certified Insurance Examiner (CIE), Market Conduct Management (MCM), and/or other pertinent designations relevant to the PBM industry, including continuing education requirements.
• Experience leading others.
• Exceptional legal research, writing, and verbal communication skills.
• Strong interpersonal, presentation, analytical, legal, and examination/audit skills.
• Excellent organizational skills and the ability to prioritize multiple tasks with competing priorities, projects and assignments using effective time management skills.
• Must be self-motivated, work well independently, possess a sense of urgency, and be flexible with directional changes.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, and Outlook) and Adobe Acrobat PDF.
• Majority of work is anticipated to be completed remotely; minor travel maybe required (e.g., NAIC National Meetings, in person strategy sessions, etc.).

Skills

PBM audit experience

Leadership experience

Legal research/writing

Communication skills

Time management

MS Office / Adobe Acrobat

Tools

Microsoft Office

Adobe Acrobat PDF

PowerPoint

Job description

Required Qualifications

• Prior PBM audit or operations experience required.
• PBM industry professionals encouraged to apply (CPBS, CPhT, etc.).
• Experience completing examinations in accordance with NAIC Market Regulation Handbook, or experience as an attorney, accountant, auditor, examiner or analyst with a state insurance department, public accounting firm, PBM, insurance company, or state/Federal agency preferred.
• Ability to obtain the Certified Insurance Examiner (CIE), Market Conduct Management (MCM), and/or other pertinent designations relevant to the PBM industry, including continuing education requirements.
• Experience leading others.
• Exceptional legal research, writing, and verbal communication skills.
• Strong interpersonal, presentation, analytical, legal, and examination/audit skills.
• Excellent organizational skills and the ability to prioritize multiple tasks with competing priorities, projects and assignments using effective time management skills.
• Must be self-motivated, work well independently, possess a sense of urgency, and be flexible with directional changes.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, and Outlook) and Adobe Acrobat PDF.
• Majority of work is anticipated to be completed remotely; minor travel maybe required (e.g., NAIC National Meetings, in person strategy sessions, etc.).