***This is a 4 month "Remote" contract role***
This role is remote
This role is for 4 months
Job Description: Pharmacy Strategy and Market Intelligence Lead
Role summary
This role leads our commercial pharmacy strategy from research to executive decisions in 90 days. It combines two areas of focus: building the necessary decision insights and understanding what carriers, PBMs, navigation companies and health systems are doing and what actually works.
The Lead will turn landscape research, competitor intelligence and our claims data into frameworks and options the executive team can decide on. The outcome by day 90 are executive team decisions that move pharmacy total cost of care (TCOC) in 2027 and place strong bets for 2028 with alignment on likely savings target and investment.
This role requires a lead who understands the pharmacy market, has deep knowledge of the competitive landscape, and able to size the options with our data to drive the executive team to decisions.
Our pharmacy strategy will need to drive the following decisions based on ability to impact TCOC in the time frames required for our book of business:
Horizon
Focus
Examples
0–12 months impact
Optimization of existing solutions
Net new solutions
Biosimilar-first formulary, infusion site of care, specialty high-cost drug clinical criteria and lifestyle support, adherence outreach
12–24 months impact
Optimization of existing solutions and partners
New new solutions
Transparent pass-through PBM terms; integrated medical and pharmacy specialty management
24–36 months
impact
Optimization of existing solutions and partners
Net new solutions
Gene therapy and oncology drug financing, pipeline watch list
Responsibilities
Strategy and decisions
Run the pharmacy strategy work end to end: plan, cadence, team tasks and a decision log.
Build the frameworks that turn research into choices: a pharmacy cost driver tree (price, use and mix by channel), an evidence grid for each intervention and an options scorecard (value, time to impact, feasibility, risk).
Size each option with the data analyst and finance partner: eligible members × engagement × effect − cost, linked to the TCOC goal and to performance guarantee exposure.
Market and competitive intelligence
Map what carriers and their PBMs (Optum Rx, CVS Caremark, Express Scripts, CarelonRx), transparent PBMs, navigation companies and health systems offer, how well it works and how it is priced.
Identify and map solutions including disruptors, early stage solutions, and established mechanisms to drive TCOC.
Track the pipeline and policy that will shape 2028 and beyond: biosimilar launches, high cost specialty drugs, cell and gene therapies, PBM reform and drug pricing policy.
Run multiple expert calls a week through an expert network, and gather what clients and benefits consultants are asking for.
Establish a competitor heat map and market brief for leadership.
Learning and team leadership
Help the executive leadership team learn the pharmacy world quickly, working with the pharmacy economics lead to develop fact base and address questions and concerns.
Coordinate the internal team of clinical pharmacist, data analyst, finance partner and client lead without managing them directly.
Use AI research tools to speed up landscape scans, evidence tables and draft materials, and check what they produce for accuracy.
What success looks like
By
Outcome
Day 30
Fact base reviewed; pharmacy spend at BOB and client split into price, use and mix; current programs and their results; PBM contract terms reviewed where available
Day 60
Evidence grid and competitor heat map complete; expert calls done; external solution landscape complete; options shortlisted
Day 90
Executive team makes key decisions to inform 2027 and 2028 roadmap tied to specific TCOC reductions, growth and retention goals.
Qualifications
Required
8+ years in healthcare strategy, with at least 3 in pharmacy benefits, PBM, payer or benefits consulting.
Strategy consulting or internal strategy experience leading work from research to executive decisions under tight deadlines.
Working knowledge of PBM economics: rebates, spread versus pass-through pricing, specialty pharmacy, and medical versus pharmacy benefit drugs.
Track record in market and competitive intelligence: primary research, expert interviews, competitor profiles and synthesis.
Comfort with claims data and financial models; able to build or direct a sizing model with finance.
Clear, concise writing and presentations for C-suite audiences.
Preferred
Experience at a carrier, PBM, transparent PBM, navigation company or benefits consultancy (Mercer, Aon, WTW).
Network of pharmacy and benefits experts to draw on quickly.
Knowledge of the specialty drug pipeline, biosimilars, GLP-1 policy and gene therapy financing.
Experience with self-funded employer clients and performance guarantees.
MBA, MPH, PharmD or similar advanced degree.
Who you work with and role details
Reports to
Chief Medical Officer
Works closely with
Pharmacy economics lead, clinical pharmacist, pharmacy data analyst, actuary, finance partner, client and consultant relations lead, legal
Executive audience
CEO and executive team
Location
Remote
Job details are sourced from the employer's original posting.
Open job postingAbout the company
Quantum Health is a health benefits navigation and support company.