PBM RFP & Pricing Lead - Remote

Position Overview

We are seeking a highly experienced PBM RFP & Pricing Lead to own and enhance our end-to-end pharmacy RFP process. This is a hands-on, strategic role focused on product ownership of the RFP process, pricing model development, and PBM financial evaluation.

Key Responsibilities

• RFP Process Ownership & Optimization
• Own and continuously improve the end-to-end PBM RFP process, from strategy and development through evaluation and finalist selection
• Standardize RFP structures, question sets, and evaluation methodologies across clients
• Identify opportunities to streamline workflows and implement tools/technology to increase efficiency and scalability
• Mentor & lead junior team members and help build and mature the RFP team’s capabilities
• PBM Financial Modeling & Underwriting Analysis
• Lead development and refinement of PBM pricing models (discount guarantees, rebate structures, admin fees, specialty pricing, etc.)
• Evaluate and normalize bidder financial proposals to enable true “apples-to-apples” comparisons
• Analyze key drivers of cost (ingredient cost, utilization, rebates, clinical programs) and identify risk/opportunity areas
• Validate underwriting assumptions and challenge PBM pricing methodologies
• Bid Evaluation & Strategy
• Translate complex PBM proposals into clear financial and strategic insights for internal teams and clients
• Identify pricing risks, hidden fees, and contractual nuances that impact total cost of care
• Serve as a subject matter expert on PBM pricing and market dynamics

Qualifications

• 5–10+ years of experience in PBM consulting, underwriting, pricing, or RFP strategy
• Deep understanding of PBM financial models, including: AWP discounts, MAC pricing, and ingredient cost structures, rebate guarantees (PMPM, per-claim, hybrid models), specialty pharmacy economics and trend drivers, administrative fees and contract financial terms
• Advanced Excel skills required; experience with SQL, data tools (Qlik, Power BI, Tableau), or RFP platforms is a strong plus
• Exposure to AI tools, automation, or data product development (or strong interest in applying AI to business processes)
• Strong analytical and problem-solving skills with high attention to detail
• Ability to translate complex data into clear, executive-level insights
• Self-starter who thrives in a build/scale environment