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Product Lead - Pharmacy Domain SME
Product Lead - Pharmacy Domain SMEBrillio • New York, NY, United States
Product Lead - Pharmacy Domain SME

Product Lead - Pharmacy Domain SME

Brillio • New York, NY, United States
15 hours ago
Job type
  • Full-time
Job description

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.
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