Bridge business and engineering teams, drive data architecture and governance in pharmacy benefit management, enabling analytics and AI use cases to optimize operations.
Project Delivery Management, Manage Fixed Price Delivery, Business Excellence, Estimations and Metrics, Client Management, SAFe- Adv. Scrum Master (SASM), SAFe- Agile SW Engineering (ASE), Communications Management, SAFe- Adv Product Manager (APM), Revenue Recognition and Invoicing, SAFe- Leading SAFe (SA), Agile, Agile Metrics and Reporting, Professional Scrum Master-CSM/ PSM1, Manage Outcome Based Delivery, Requirements Creation/User Stories, Digital Accumen, Agile Coaching, Change Management (Project Management), Agile SAFE framework, Backlog Grooming, Business Operations, Agile Facilitation and Leaders
Specialization
Project Management: Associate Director, Delivery & Program Management
Job requirements
Job Description: Data Strategist – Pharmacy Benefit ________________________________________ Overview We are seeking a highly skilled Data Strategist with deep experience in the Pharmacy Benefit Management (PBM) domain and strong expertise across transactional and analytical data stores, both on cloud and on-prem. This role enables data-driven transformation across PBM operations by bridging business teams, product teams, and engineering. The ideal candidate combines PBM domain understanding with strong strategic data architecture literacy—particularly across Mainframe/legacy adjudication systems, Teradata, Postgres, and Databricks. ________________________________________ Key Responsibilities 1. Strategic Data Leadership • Develop end-to-end data strategy across PBM functional areas (claims adjudication, formulary, PA/UM, specialty, clinical programs, network operations). • Translate business goals into data capabilities, including transactional readiness, analytical models, and AI/insight enablement. • Define the North Star architecture centered on: o Databricks for analytics & AI enablement o Postgres for modern operational/transactional workloads o Teradata as the existing enterprise analytical backbone o Mainframe–based adjudication and operational systems 2. Business–Technology Bridge • Drive alignment between business leads, pharmacy operations, product management, data engineering, and architecture teams. • Capture and refine data requirements tied to real PBM workflows and regulatory needs. • Create clear data documentation: canonical models, lineage, definitions, integration patterns, domain mappings. 3. Data Architecture & Modeling • Guide design of transactional data structures (claims, member, provider, formulary, PA, specialty). • Partner with engineering to shape analytical datasets in Teradata and Databricks for cost, quality, adherence, and operational insights. • Shape migration paths from legacy/mainframe data to modern analytical or operational stores. 4. Governance & Quality • Establish governance models around ownership, metadata, critical data elements, and stewardship. • Lead data quality and observability initiatives across PBM domains. • Ensure compliance with PHI rules, HIPAA, and audit expectations. 5. Product & AI Enablement • Enable analytics and AI use cases such as: o Real-time PA insights o Cost optimization / formulary alignment o Fraud, Waste, Abuse o Adherence prediction & member targeting o Pharmacist enablement & specialty workflows • Support product teams in defining data-driven roadmaps and measurable value outcomes. ________________________________________ Required Qualifications • 7–12+ years of experience in healthcare with 4–5+ years in PBM or specialty pharmacy. • Strong familiarity with PBM data domains: o NCPDP claims o Formulary & benefit design o PA/UM data o Network & pharmacy data o Specialty/hub workflows o Rebate & financial/reconciliation data • Ability to work across mainframe, Teradata, Postgres, and Databricks ecosystems. • Strong SQL proficiency and experience guiding data modeling conversations. • Experience collaborating with product, engineering, business operations, and compliance. ________________________________________ Preferred Qualifications • Experience modernizing PBM data & analytics ecosystems. • Familiarity with ML/AI enablement on Databricks. • Knowledge of NCPDP, HL7, FHIR standards. • Experience working in fast-paced consulting or digital product environments. ________________________________________ Success Metrics • Adoption of unified data models across PBM functions. • Improved data quality and reduced downstream rework. • Acceleration of insights and AI use case delivery. • Strong business–technology alignment and faster execution cycles. • Tangible improvements in clinical outcomes, cost optimization, or operational efficiency.
Brillio is a global leader in Enterprise Digital Transformation Solutions, partnering with companies to drive business improvement and competitiveness through innovative technology solutions.
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