PBM RFP & Pricing Lead — AI-Driven Strategy

Digital Insurance LLC; United States; Remote; USD 90,000 - 150,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Retirement plan

Learning & development

Job summary

OneDigital is seeking a seasoned PBM RFP & Pricing Lead to own and optimize the end-to-end PBM RFP process. You will drive pricing models, underwriting analyses, and bid evaluation while mentoring the RFP team.

The role emphasizes AI-driven capabilities, scalable tools, and cross-functional collaboration with audit, analytics, and consulting teams. The base pay ranges nationwide, with performance-based incentives.

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.
• Experience building and/or evaluating PBM RFPs and bidder responses.

Responsibilities

• RFP Process Ownership & Optimization: Own and improve end-to-end PBM RFP process across strategy to finalist selection.
• PBM Financial Modeling & Underwriting: Lead pricing models, analyze cost drivers and validate assumptions.
• Bid Evaluation & Strategy: Translate proposals into clear financial insights and support negotiations.
• Product, AI & Capability Development: Own RFP tools and AI-driven capabilities to enhance the process.

Skills

PBM knowledge

Pricing models

Excel

SQL

Data tools

AI tools

Analytical thinking

Communication

Stakeholder mgmt

Education

Bachelor's degree in a relevant field

Tools

SQL

Power BI

Tableau

RFP platforms

Job description

OneDigital is seeking a seasoned PBM RFP & Pricing Lead to own and optimize the end-to-end PBM RFP process. You will drive pricing models, underwriting analyses, and bid evaluation while mentoring the RFP team.

The role emphasizes AI-driven capabilities, scalable tools, and cross-functional collaboration with audit, analytics, and consulting teams. The base pay ranges nationwide, with performance-based incentives.