1099 Contractor: Pharmacy Strategy and Market Intelligence Lead

Quantum Health, Inc.; Philadelphia (Philadelphia County); À distance; USD 165 000 - 248 000; Plein temps

Avantages offerts par ce poste

Remote contract

Résumé du poste

Quantum Health, Inc. is seeking a strategic Lead for Pharmacy Strategy and Market Intelligence on a 4-month remote contract. The role guides our pharmacy strategy from landscape research to executive decisions, aligning with TCOC reduction targets and 2028 plans.

The candidate will convert landscape scans, competitive intelligence and claims data into actionable frameworks, working with finance and data teams to size options and present recommended paths to the CEO and leadership group.

Qualifications

• 8+ years in healthcare strategy with at least 3 in pharmacy benefits, PBM, payer or benefits consulting.
• Strategy consulting or internal strategy experience leading work from research to executive decisions under tight deadlines.
• Working knowledge of PBM economics: rebates, spread versus pass-through pricing, specialty pharmacy, and medical versus pharmacy benefit drugs.

Responsabilités

• Run the pharmacy strategy work end to end: plan, cadence, team tasks and a decision log.
• Build the frameworks that turn research into choices: a pharmacy cost driver tree, an evidence grid and an options scorecard.
• Size each option with the data analyst and finance partner: eligible members × engagement × effect − cost, linked to the TCOC goal.
• Map carriers and their PBMs, transparent PBMs, navigation companies and health systems; assess offerings and pricing.
• Track the pipeline and policy that will shape 2028 and beyond: biosimilar launches, high-cost drugs, gene therapies and drug pricing policy.
• Run expert calls weekly and establish a competitor heat map and market brief for leadership.
• Help the executive leadership team learn the pharmacy world quickly and coordinate the internal team without direct management.
• Use AI research tools to speed landscape scans, evidence tables and draft materials, and check outputs for accuracy.

Connaissances

Pharmacy strategy

PBM economics

Market intelligence

Executive storytelling

Data-driven decision making

AI landscape scanning

Formation

MBA/MPH/PharmD or related

Outils

AI research tools

Claims data analysis

Description du poste

1099 Contractor: Pharmacy Strategy and Market Intelligence Lead

This is a 4 month "Remote" contract role

This role is remote

This role is for 4 months

Job Description: Pharmacy Strategy and Market Intelligence Lead

Role summary

This role leads our commercial pharmacy strategy from research to executive decisions in 90 days. It combines two areas of focus: building the necessary decision insights and understanding what carriers, PBMs, navigation companies and health systems are doing and what actually works.

The Lead will turn landscape research, competitor intelligence and our claims data into frameworks and options the executive team can decide on. The outcome by day 90 are executive team decisions that move pharmacy total cost of care (TCOC) in 2027 and place strong bets for 2028 with alignment on likely savings target and investment.

This role requires a lead who understands the pharmacy market, has deep knowledge of the competitive landscape, and able to size the options with our data to drive the executive team to decisions.

Our pharmacy strategy will need to drive the following decisions based on ability to impact TCOC in the time frames required for our book of business:

Horizon

Focus

Examples

0–12 months impact

Optimization of existing solutions

Net new solutions

Biosimilar‑first formulary, infusion site of care, specialty high-cost drug clinical criteria and lifestyle support, adherence outreach

12–24 months impact

Optimization of existing solutions and partners

New new solutions

Transparent pass‑through PBM terms; integrated medical and pharmacy specialty management

24–36 months

impact

Optimization of existing solutions and partners

Net new solutions

Gene therapy and oncology drug financing, pipeline watch list

Responsibilities

Strategy and decisions

• Run the pharmacy strategy work end to end: plan, cadence, team tasks and a decision log.

• Build the frameworks that turn research into choices: a pharmacy cost driver tree (price, use and mix by channel), an evidence grid for each intervention and an options scorecard (value, time to impact, feasibility, risk).

• Size each option with the data analyst and finance partner: eligible members × engagement × effect − cost, linked to the TCOC goal and to performance guarantee exposure.

Market and competitive intelligence

• Map what carriers and their PBMs (Optum Rx, CVS Caremark, Express Scripts, CarelonRx), transparent PBMs, navigation companies and health systems offer, how well it works and how it is priced.

• Identify and map solutions including disruptors, early stage solutions, and established mechanisms to drive TCOC.

• Track the pipeline and policy that will shape 2028 and beyond: biosimilar launches, high cost specialty drugs, cell and gene therapies, PBM reform and drug pricing policy.

• Run multiple expert calls a week through an expert network, and gather what clients and benefits consultants are asking for.

• Establish a competitor heat map and market brief for leadership.

Learning and team leadership

• Help the executive leadership team learn the pharmacy world quickly, working with the pharmacy economics lead to develop fact base and address questions and concerns.

• Coordinate the internal team of clinical pharmacist, data analyst, finance partner and client lead without managing them directly.

• Use AI research tools to speed up landscape scans, evidence tables and draft materials, and check what they produce for accuracy.

What success looks like

By

Outcome

Day 30

Fact base reviewed; pharmacy spend at BOB and client split into price, use and mix; current programs and their results; PBM contract terms reviewed where available

Day 60

Evidence grid and competitor heat map complete; expert calls done; external solution landscape complete; options shortlisted

Day 90

Executive team makes key decisions to inform 2027 and 2028 roadmap tied to specific TCOC reductions, growth and retention goals.

Qualifications

Required

• 8+ years in healthcare strategy, with at least 3 in pharmacy benefits, PBM, payer or benefits consulting.

• Strategy consulting or internal strategy experience leading work from research to executive decisions under tight deadlines.

• Working knowledge of PBM economics: rebates, spread versus pass-through pricing, specialty pharmacy, and medical versus pharmacy benefit drugs.

• Track record in market and competitive intelligence: primary research, expert interviews, competitor profiles and synthesis.

• Comfort with claims data and financial models; able to build or direct a sizing model with finance.

• Clear, concise writing and presentations for C-suite audiences.

Preferred

• Experience at a carrier, PBM, transparent PBM, navigation company or benefits consultancy (Mercer, Aon, WTW).

• Network of pharmacy and benefits experts to draw on quickly.

• Knowledge of the specialty drug pipeline, biosimilars, GLP-1 policy and gene therapy financing.

• Experience with self-funded employer clients and performance guarantees.

• MBA, MPH, PharmD or similar advanced degree.

Who you work with and role details

Reports to: Chief Medical Officer

Works closely with: Pharmacy economics lead, clinical pharmacist, pharmacy data analyst, actuary, finance partner, client and consultant relations lead, legal

Executive audience: CEO and executive team

Location: Remote