Project Delivery Management, Manage Fixed Price Delivery, Business Excellence, Estimations and Metrics, Client Management, SAFe- Adv. Scrum Master (SASM), SAFe- Agile SW Engineering (ASE), Communications Management, SAFe- Adv Product Manager (APM), Revenue Recognition and Invoicing, SAFe- Leading SAFe (SA), Agile, Agile Metrics and Reporting, Professional Scrum Master-CSM/ PSM1, Manage Outcome Based Delivery, Requirements Creation/User Stories, Digital Accumen, Agile Coaching, Change Management (Project Management), Agile SAFE framework, Backlog Grooming, Business Operations, Agile Facilitation and Leaders
Specialization
Project Management: Associate Director, Delivery & Program Management
Job requirements
Job Description: Data Strategist – Pharmacy Benefit ________________________________________ Overview We are seeking a highly skilled Data Strategist with deep experience in the Pharmacy Benefit Management (PBM) domain and strong expertise across transactional and analytical data stores, both on cloud and on-prem. This role enables data-driven transformation across PBM operations by bridging business teams, product teams, and engineering. The ideal candidate combines PBM domain understanding with strong strategic data architecture literacy—particularly across Mainframe/legacy adjudication systems, Teradata, Postgres, and Databricks. ________________________________________ Key Responsibilities 1. Strategic Data Leadership • Develop end-to-end data strategy across PBM functional areas (claims adjudication, formulary, PA/UM, specialty, clinical programs, network operations). • Translate business goals into data capabilities, including transactional readiness, analytical models, and AI/insight enablement. • Define the North Star architecture centered on: o Databricks for analytics & AI enablement o Postgres for modern operational/transactional workloads o Teradata as the existing enterprise analytical backbone o Mainframe–based adjudication and operational systems 2. Business–Technology Bridge • Drive alignment between business leads, pharmacy operations, product management, data engineering, and architecture teams. • Capture and refine data requirements tied to real PBM workflows and regulatory needs. • Create clear data documentation: canonical models, lineage, definitions, integration patterns, domain mappings. 3. Data Architecture & Modeling • Guide design of transactional data structures (claims, member, provider, formulary, PA, specialty). • Partner with engineering to shape analytical datasets in Teradata and Databricks for cost, quality, adherence, and operational insights. • Shape migration paths from legacy/mainframe data to modern analytical or operational stores. 4. Governance & Quality • Establish governance models around ownership, metadata, critical data elements, and stewardship. • Lead data quality and observability initiatives across PBM domains. • Ensure compliance with PHI rules, HIPAA, and audit expectations. 5. Product & AI Enablement • Enable analytics and AI use cases such as: o Real-time PA insights o Cost optimization / formulary alignment o Fraud, Waste, Abuse o Adherence prediction & member targeting o Pharmacist enablement & specialty workflows • Support product teams in defining data-driven roadmaps and measurable value outcomes. ________________________________________ Required Qualifications • 7–12+ years of experience in healthcare with 4–5+ years in PBM or specialty pharmacy. • Strong familiarity with PBM data domains: o NCPDP claims o Formulary & benefit design o PA/UM data o Network & pharmacy data o Specialty/hub workflows o Rebate & financial/reconciliation data • Ability to work across mainframe, Teradata, Postgres, and Databricks ecosystems. • Strong SQL proficiency and experience guiding data modeling conversations. • Experience collaborating with product, engineering, business operations, and compliance. ________________________________________ Preferred Qualifications • Experience modernizing PBM data & analytics ecosystems. • Familiarity with ML/AI enablement on Databricks. • Knowledge of NCPDP, HL7, FHIR standards. • Experience working in fast-paced consulting or digital product environments. ________________________________________ Success Metrics • Adoption of unified data models across PBM functions. • Improved data quality and reduced downstream rework. • Acceleration of insights and AI use case delivery. • Strong business–technology alignment and faster execution cycles. • Tangible improvements in clinical outcomes, cost optimization, or operational efficiency.
