PBM Compliance & Reporting Analyst (Healthcare)

Location: Remote-first work environment; US-focused regulatory reporting and benefits.

Salary: $62,400–$78,000 annually, plus short-term incentive eligibility.

Company

hirify.global operates pharmacy benefit management programs and supports healthcare benefits administration.

What you will do

• Support federal and state regulatory reporting, including CMS Section 111, CMS RxDC, APCD, DOI filings, DLR reporting, and other state-mandated pharmacy submissions.
• Collect, prepare, validate, reconcile, and submit eligibility, demographic, accumulator, and claims data while investigating discrepancies and documenting resolutions.
• Maintain reporting schedules, compliance tracking logs, reporting inventories, audit-ready documentation, SOPs, Confluence pages, work instructions, and reporting guides.
• Support DOI inquiries, audits, regulatory reviews, submission activities, and state DOI and CMS-related systems.
• Use PBM Source, Excel, Jira, and other internal tools to manage workflows, tickets, dashboards, KPIs, compliance metrics, and reporting trends.
• Coordinate with Legal Operations, Data Operations, IT, Pharmacy Operations, Eligibility Vendors, PBM partners, regulatory agencies, and external stakeholders.

Requirements

• 1–3 years of experience in PBM operations, healthcare compliance, regulatory reporting, or data operations.
• Proficiency in Excel, including VLOOKUP/XLOOKUP, Pivot Tables, data validation, reconciliation, and data cleansing.
• Strong analytical, organizational, and communication skills, with the ability to manage multiple projects and deadlines with high attention to detail.

Nice to have

• Bachelor’s degree.
• Foundational knowledge of CMS Section 111 and RxDC reporting requirements and state DOI reporting processes.
• PBM industry experience and experience with Jira, Confluence, PBM Source, audits, or regulatory reviews.
• Working knowledge of SQL, Python, SAS, or Snowflake.

Culture & Benefits

• Remote-first work environment with company-provided computer and monitors and high-speed internet reimbursement.
• Medical, dental, vision, disability, life insurance, pet insurance, and mental health and EAP benefits; the company pays 100% of HDHP premiums and selected other premiums.
• 401(k) with employer match up to 3.5% after 60 days.
• Ten company holidays, a floating holiday, Community Service Day, and paid new-parent leave.
• Tuition reimbursement for accredited degree programs.