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.
Seniority level: Mid‑Senior level
Employment type: Full‑time
Job function: Information Technology
#J-18808-Ljbffr
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.
Seniority level: Mid‑Senior level
Employment type: Full‑time
Job function: Information Technology
#J-18808-Ljbffr