Quantum Health

Tailored healthcare navigation for employers

Pharmacy Strategy and Market Intelligence Lead

Corporate StrategyConfirmed live in the last 24 hours

Full-timeRemote in USANo salary listed

About the Job

Requirements

At least 8 years of healthcare strategy experience, including at least 3 years in pharmacy benefits, pharmacy benefit management, payer, or benefits consulting.
Strategy consulting or internal strategy experience leading work from research to executive decisions under tight deadlines.
Working knowledge of pharmacy benefit management economics, including rebates, spread versus pass-through pricing, specialty pharmacy, and medical versus pharmacy benefit drugs.
A track record in market and competitive intelligence, including primary research, expert interviews, competitor profiles, and synthesis.
Comfort with claims data and financial models, with the ability to build or direct a sizing model with finance.
Clear, concise writing and presentations for C-suite audiences.

Responsibilities

Run the pharmacy strategy work end to end, including planning, cadence, team tasks, and a decision log.
Build frameworks that turn research into choices: a pharmacy cost driver tree covering price, use, and mix by channel; an evidence grid for each intervention; and an options scorecard covering value, time to impact, feasibility, and risk.
Size each option with the data analyst and finance partner using eligible members × engagement × effect − cost, linked to the total cost of care goal and performance guarantee exposure.
Map what carriers and their pharmacy benefit managers, transparent pharmacy benefit managers, 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 total cost of care.
Track the pipeline and policy that will shape 2028 and beyond, including biosimilar launches, high-cost specialty drugs, cell and gene therapies, pharmacy benefit manager 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.
Help the executive leadership team learn the pharmacy field quickly, working with the pharmacy economics lead to develop a 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 artificial intelligence research tools to speed up landscape scans, evidence tables, and draft materials, and check their output for accuracy.

Desired Qualifications

Experience at a carrier, pharmacy benefit manager, transparent pharmacy benefit manager, navigation company, or benefits consultancy such as Mercer, Aon, or WTW.
A network of pharmacy and benefits experts to draw on quickly.
Knowledge of the specialty drug pipeline, biosimilars, glucagon-like peptide-1 policy, and gene therapy financing.
Experience with self-funded employer clients and performance guarantees.
A Master of Business Administration, Master of Public Health, Doctor of Pharmacy, or similar advanced degree.

***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

About the Company

Quantum Health

Tailored healthcare navigation for employers

Quantum Health provides healthcare navigation and care coordination services aimed at employers who want to optimize their employee benefits. Its offerings include tailored navigation programs that blend care coordination with clinical expertise to simplify how employees access care, manage complex conditions, and improve health outcomes. The product works by guiding members through the healthcare system, coordinating services across providers, and addressing social determinants of health to reduce unnecessary costs and improve ROI for employers. Quantum Health differentiates itself by delivering holistic, employer-focused solutions that explicitly focus on outcomes and workforce well-being, rather than generic patient navigation alone. The company’s goal is to help employers lower healthcare costs while boosting member satisfaction and health results through coordinated care and tailored support.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Dublin, OH
Founded: 1999

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