Pricing Consultant

The Prism Health Group; United States; On-site; USD 120,000 - 170,000; Full time

Job summary

The Prism Health Group is seeking an analytical Pricing Consultant to support complex pharmacy benefit consulting engagements and help clients understand the financial implications of PBM proposals, contract terms, and program performance.

You will perform pricing and financial analyses, develop client-ready deliverables, support procurement and market-check engagements, and collaborate with consulting leaders and cross-functional teams.

Qualifications

• Bachelor's degree in finance, economics, actuarial science, mathematics, business, healthcare administration, data analytics, or a related field.
• 7+ years of pricing, financial analysis, pharmacy benefits, healthcare consulting, underwriting, or related analytical discipline.
• Advanced proficiency in Microsoft Excel, including complex formulas, data validation, reconciliation, and financial modeling.
• Strong analytical and problem-solving skills with attention to accuracy, consistency, and documentation.
• Ability to interpret complex data and communicate findings in clear, client-ready language.

Responsibilities

• Analyze pricing terms, rebates, and financial guarantees in PBM arrangements.
• Develop pricing models comparing incumbent performance, vendor proposals, benchmarks, and alternative strategies.
• Normalize assumptions for transparent financial comparisons and defensible analyses.
• Perform quality-control reviews, reconcile data, and document methodologies.
• Translate model outputs into findings, implications, and recommended steps for clients.
• Support PBM procurement, market checks, renewals, and contract evaluations from data intake to client presentation.
• Prepare client-ready analyses and exhibits tailored to audience and engagement objectives.
• Participate in client and vendor meetings, capture decisions, and follow up on questions.
• Partner with leaders to ensure alignment with scope, methodology, and timelines.
• Review pricing terms and performance against contractual commitments; identify risks and opportunities.
• Coordinate with clinical, operational, and contracting resources for integrated recommendations.
• Contribute to pricing models, templates, SOPs, and quality-control tools.
• Identify opportunities to improve analytical efficiency, documentation, and scalability.

Skills

Advanced Excel

Data analysis

Pricing analysis

Financial modeling

Communication skills

Organizational skills

Education

Bachelor's degree in finance / economics / math

Tools

SQL

Power BI

Power Query

Job description

Prism is an independent pharmacy benefit consulting firm dedicated to serving as the strategic and financial advocate for self-insured employers and plan sponsors. We provide independent, data-driven pharmacy benefit management consulting that helps clients evaluate PBM performance, understand pricing dynamics, identify savings opportunities, and make informed benefit decisions. As our consulting practice grows, we are looking for a detail-oriented and collaborative pricing professional who is excited to contribute to rigorous client analyses and scalable consulting solutions.

Prism was founded in 2019, on the premise that the healthcare industry lacked an independent and objective voice to those struggling to reign-in their pharmacy program performance. In addition to deploying conventional pharmacy consulting solutions, Prism assists self-funded plan sponsors, health plans, and third-party administrator (TPA) organizations to thoughtfully develop and implement uniquely tailored enterprise pharmacy strategies and solutions.

Role Overview

This is an opportunity for an analytical pricing professional to support complex pharmacy benefit consulting engagements and help clients understand the financial implications of PBM proposals, contract terms, and program performance. As a Pricing Consultant at Prism, you will perform pricing and financial analyses, develop client-ready deliverables, support procurement and market-check engagements, and collaborate with consulting leaders and cross-functional team members. This role is ideal for someone who combines strong analytical discipline with sound business judgment, clear communication, and an ownership mindset.

What You’ll Own

• Analyze pharmacy claims, utilization, pricing guarantees, rebates, administrative fees, and other financial components of PBM arrangements
• Develop and maintain pricing models that compare incumbent performance, vendor proposals, market benchmarks, and alternative benefit strategies
• Normalize key assumptions and variables to support consistent, transparent, and defensible financial comparisons
• Perform quality-control reviews, reconcile data, investigate variances, and document methodologies and assumptions
• Translate complex model outputs into clear findings, financial implications, and recommended next steps

Client Engagement Support

• Support PBM request for proposal, market check, renewal, and contract evaluation engagements from data intake through final client presentation
• Prepare client-ready analyses, exhibits, executive summaries, and presentation materials tailored to the audience and engagement objectives
• Participate in client and vendor meetings, capture decisions and follow-up items, and support timely resolution of analytical questions
• Partner with consulting leaders to respond to client requests while maintaining alignment with scope, methodology, and delivery timelines

PBM Contract & Performance Evaluation

• Review pricing terms and financial guarantees, including discount, dispensing fee, rebate, specialty, and administrative fee provisions
• Assess performance results against contractual commitments and identify potential financial risks, gaps, or opportunities
• Support evaluation of proposal language and pricing methodologies to improve comparability across PBM vendors
• Coordinate with clinical, operational, and contracting resources to incorporate relevant considerations into the overall client recommendation

Process Improvement & Knowledge Development

• Contribute to the development and maintenance of pricing models, templates, standard operating procedures, and quality-control tools
• Identify opportunities to improve analytical efficiency, consistency, documentation, and scalability across engagements
• Maintain awareness of PBM pricing practices, market developments, and emerging pharmacy benefit trends
• Share knowledge with team members and contribute to a collaborative, high-accountability consulting environment

What We’re Looking For

Required Qualifications

• Bachelor’s degree in finance, economics, actuarial science, mathematics, business, healthcare administration, data analytics, or a related field
• Seven (7) years of experience in pricing, financial analysis, pharmacy benefits, healthcare consulting, underwriting, or a related analytical discipline
• Advanced proficiency in Microsoft Excel, including complex formulas, data validation, reconciliation, and financial modeling
• Strong analytical and problem-solving skills with careful attention to accuracy, consistency, and documentation
• Ability to interpret complex data and communicate findings in clear, concise, client-ready language
• Highly organized self-starter who can manage multiple priorities and deliverables in a deadline-driven environment

Preferred Qualifications

• Experience at a PBM, pharmacy benefit consulting firm, health plan, broker, actuarial firm, or healthcare organization
• Working knowledge of PBM pricing components, pharmacy claims data, rebate structures, specialty pharmacy, and financial guarantees
• Experience supporting PBM procurement, market-check, renewal, contract review, or performance reconciliation engagements
• Experience with SQL, Power Query, Power BI, or other data analysis and reporting tools
• Experience developing reusable analytical tools, templates, or documented workflows

Who Thrives in This Role

• You are analytically rigorous: you validate assumptions, investigate inconsistencies, and produce work that is accurate and defensible
• You have an ownership mentality: you take initiative, follow through, and communicate risks or constraints early
• You are client-focused: you can turn detailed analyses into practical insights that support informed decisions
• You are collaborative and adaptable: you work effectively across disciplines and adjust to changing engagement needs without losing sight of quality
• You are improvement-minded: you look for ways to strengthen models, processes, documentation, and the overall client experience