PBM Strategy & Implementation Consultant

Overview

On Site
BASED ON EXPERIENCE
Contract - Independent
Contract - W2
Contract - 6+ mo(s)

Skills

PBM IMPLEMENTATION
PHARMACY BENEFIT
PHARMACY TRANSITION
PROJECT MANAGER
IMPLEMENTATION LEAD
FORMULARY
ADJUDICATION
REBATES
PHARMACY OPERATIONS
CAREMARK
OPTUM
EXPRESS SCRIPTS
MEDIMPACT
COMMERCIAL
MEDICARE
MEDICAID

Job Details

Hiring: PBM Strategy & Implementation Consultant

Primarily Remote | Contract-to-Hire

W2: Up to $142/hr | C2C: Up to $166/hr

About the Role:

We re looking for a hands-on leader with deep expertise in PBM implementations and pharmacy supply chain strategy to lead a high-impact transition initiative. This role is perfect for someone who thrives in ambiguity, influences senior stakeholders, and drives strategy from concept to execution.

Must have led PBM transitions not just supported or observed.

Core Responsibilities:

Strategy Execution & Leadership

  • Lead the end-to-end PBM and supply chain implementation including execution planning, stakeholder alignment, and readiness efforts.
  • Drive day-to-day delivery while partnering with business sponsors, IT, PMO, and vendors.
  • Own business milestones and execution timelines.

Contracts & Vendor Management

  • Manage PBM and pharmacy supply chain contracts, SOWs, and vendor relationships.
  • Monitor and influence vendor performance, addressing risks and implementation challenges swiftly.

Business Value & Reporting

  • Build and communicate a clear value story, showing ROI, savings, and service enhancements.
  • Track value realization and continuously refine strategy to maximize impact.

Cross-Functional Leadership

  • Collaborate across business, IT, PMO, and vendor teams to ensure operational integration and readiness.
  • Translate business goals into actionable tasks and prepare impacted teams through communication, training, and documentation.

Risk & Performance Optimization

  • Identify operational gaps and offer data-backed recommendations to improve efficiency, cost control, and compliance.
  • Lead mitigation planning, proactively managing business risks and escalations.

Must-Have Qualifications:

  • 5-10+ years in PBM operations, health plan strategy, or pharmacy supply chain.
  • Led at least one end-to-end PBM transition (not just advisory roles).
  • Deep hands-on experience in:
  • Claims adjudication
  • Formulary management
  • Rebates/Discount strategy
  • Pharmacy network design
  • Experience in commercial health plans (Medicare/Medicaid is a plus).
  • Demonstrated ability to influence C-level stakeholders and vendors.

Preferred Skills & Experience:

  • Worked with Caremark or another major PBM.
  • Hands-on experience with rebate contracts or negotiation.
  • Familiarity with Medicare Part D, Medicaid, or UM workflows (e.g., prior auth, step therapy).
  • MBA or graduate degree in healthcare/business is a plus.

Ideal Candidate Traits:

  • Drives execution doesn t wait for direction.
  • Can jump into ambiguous, evolving projects and shape structure.
  • Manages up, down, and across functions seamlessly.
  • Balances strategic thinking with hands-on execution.

Ready to own a high-visibility PBM transformation and make measurable impact in a lean, empowered team?

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