Product Lead - Pharmacy Domain SME
il y a 2 jours
New York
About Brillio Brillio is a global digital transformation partner helping leading Healthcare and Life Sciences organizations reimagine their businesses through data, AI, and digital product innovation. Our Consulting & Advisory practice partners with CXOs to define business and technology strategy, design operating models, and build next-generation products and platforms that create measurable outcomes in speed, experience, and affordability. Within Healthcare, Brillio is driving the next era of PBM and pharmacy transformation — leveraging digital, AI, and interoperability to reshape patient access, provider collaboration, and value-based healthcare ecosystems. Role Overview We are seeking a Senior Manager – Consulting (PBM Product Strategy & Transformation) who combines deep domain expertise in the PBM ecosystem with strong experience in digital product strategy, data modernization, and AI-enabled transformation. This role is ideal for a strategic consultant or product leader who has partnered with PBMs or payer pharmacy divisions to build digital platforms, modernize benefit operations, and drive AI-powered clinical and financial outcomes. You will act as both a strategic advisor and product strategist, working with client executives to define transformation roadmaps, lead product discovery, and shape scalable, data-driven solutions across the PBM value chain. Key Responsibilities • Define product and digital transformation strategies across the PBM lifecycle — from formulary design and claims processing to clinical programs, member engagement, and network optimization., • Lead consulting and product strategy engagements focused on:, • AI-driven formulary and benefit optimization, • Digital prior authorization and utilization management, • Pharmacy network and reimbursement optimization, • Member affordability, adherence, and savings programs, • Interoperable data and analytics platforms for PBM operations and reporting, • Translate business goals, regulatory requirements, and operational complexities into product architectures, platform blueprints, and MVP roadmaps., • Collaborate with Brillio’s AI Foundry, Data Engineering, and Product teams to design AI-first PBM solutions that are compliant, explainable, and value-driven., • Partner with client product, IT, and clinical operations teams to launch and scale digital products with measurable ROI., • Define KPIs and business value frameworks to track adoption, outcomes, and financial impact., • Contribute to Brillio’s PBM IP and accelerator portfolio, co-developing assets such as benefit simulation engines, AI adjudication models, or affordability dashboards., • Build and mentor a cross-functional team of consultants, product managers, and domain specialists delivering PBM transformation programs., • Support practice growth and go-to-market efforts, contributing to proposals, thought leadership, and client solutioning. Required Experience • 10–12 years of consulting, product strategy, or transformation experience, with a strong focus on Healthcare Payers and PBMs., • Deep understanding of PBM operations and value chain, including formulary management, claims adjudication, rebate management, benefit design, specialty pharmacy integration, and regulatory compliance., • Proven success in defining or managing digital product portfolios or transformation programs within PBM or payer environments., • Experience leveraging AI/ML and advanced analytics in use cases such as cost optimization, adherence prediction, fraud/waste/abuse, or patient affordability., • Strong background in product strategy and agile delivery — translating business needs into platform requirements and MVPs., • Familiarity with healthcare interoperability and data standards (NCPDP, FHIR, HL7)., • Consulting experience with top-tier or healthcare-specialized firms preferred., • Excellent executive communication, storytelling, and stakeholder management skills. Preferred Qualifications • MBA or Master’s degree in Healthcare, Business, or Engineering., • Prior experience with leading PBMs or payer pharmacy divisions (e.g., CVS Caremark, Express Scripts, OptumRx, Navitus, Prime Therapeutics, MedImpact, etc.)., • Understanding of rebate and contracting analytics, 340B program impact, and regulatory frameworks (CMS, ERISA, state pharmacy mandates)., • Demonstrated ability to drive cross-functional product innovation involving clinical, financial, and technology teams., • Track record of contributing to practice or IP growth within a consulting or digital organization. Why Brillio • Join a fast-growing consulting and advisory practice driving the digital reinvention of healthcare ecosystems., • Shape next-generation PBM platforms and AI-first solutions that redefine access, affordability, and outcomes., • Collaborate with industry leaders, innovators, and Brillio’s AI Foundry to deliver measurable transformation., • Be part of a flat, entrepreneurial culture that rewards initiative, innovation, and tangible results., • Grow your career toward Associate Director or Director-level leadership, leading Brillio’s PBM product strategy and consulting portfolio.