Senior Policy Lead: Payer/PBM Pricing & Data Standards

MITRE; Bedford (MA); On-site; USD 155,000 - 233,000; Full time

Job summary

MITRE is seeking a senior analyst in the CMS Programs Division to shape prescription drug pricing and machine-readable data standards. You will bring deep payer and PBM expertise to advise across policy, data architecture, and implementation guidance for CMS projects involving pricing disclosures and data reporting.

You will collaborate with multidisciplinary teams, translate complex healthcare processes into concrete requirements, and communicate with federal stakeholders to ensure practical,

Qualifications

• Significant healthcare industry experience with health plans or PBMs.
• Ability to translate policy and regulatory requirements into actionable data specs.
• Experience communicating with federal stakeholders and multidisciplinary teams.

Responsibilities

• Provide senior subject-matter expertise on health plan and PBM models and pricing.
• Advise teams on policy, standards, data architecture, and implementation guidance.
• Translate complex processes into clear requirements for data standards and architecture.
• Assess feasibility and utility of policy, data, and technical requirements.
• Identify which pricing data elements can be standardized across payers.
• Communicate concepts to federal stakeholders and interdisciplinary teams.

Skills

PBM knowledge

Payer operations

Policy analysis

Data standards

Regulatory understanding

Education

Bachelor's degree

Job description

MITRE is seeking a senior analyst in the CMS Programs Division to shape prescription drug pricing and machine-readable data standards. You will bring deep payer and PBM expertise to advise across policy, data architecture, and implementation guidance for CMS projects involving pricing disclosures and data reporting.

You will collaborate with multidisciplinary teams, translate complex healthcare processes into concrete requirements, and communicate with federal stakeholders to ensure practical,