Product Lead - Pharmacy Domain SME

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